2004 Prescription Drug State Legislation

Data complete for 2004; revised and reposted: January 2008

This is an Archive Report covering calendar year 2004 actions only. For more recent activity see NCSL reports on:
2007 Prescription Drug State Legislation.

For 2004, state legislatures again grappled with a wide variety of bills affecting pharmaceuticals.¹ Recent reports indicate that the double-digit annual cost increases of 13 to 18 percent in 2002 have moderated to below 10 percent for some segments of the purchasing market this year.² The number of states with enacted or operational pharmaceutical assistance programs reached a new high of 39 states as of May 2004, prior to the start of the federal Medicare discount program. Despite numerous past year actions, more than 320 bills and resolutions were filed for 2004 sessions. Many of these measures address discount or subsidy programs, as well as other access, disclosure and cost containment strategies. Pharmaceutical bills were filed in 43 out of the 44 states that held sessions in 2004.  Six states had no regular session in 2004.

Among new trends for 2004 are at least 62 bills and resolutions seeking to adjust state programs in response to the federal Medicare Prescription Drug Improvement, and Modernization Act of 2003 (P.L.108-173). Also, 27 states addressed state importation of prescription drugs.

In 2004,almost half the states had measures aimed at providing pharmaceutical discounts. About a dozen states each considered programs to allow or regulate reuse of unused drugs from nursing homes and similar facilities, sought to regulate pharmacy benefit managers (PBMs) or disclose marketing costs.  Eight states examined expanded use of the federal 340B drug discount program, while 14 discussed bulk or coordinated purchasing. In October, New Jersey became the first state to tackle flu vaccine rationing and pricing.

2004 LAWS:  By the end of all 2004 sessions, bills were signed or became law in 25 states: Alaska, California (5), Connecticut (2), the District of Columbia, Florida, Hawaii (4), Illinois, Indiana (2), Louisiana, Maine (4), Maryland, Massachusetts (2), Missouri, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Rhode Island (7), South Dakota (3), Tennessee, Vermont, Virginia (2), West Virginia (2), Wisconsin, and Wyoming.

Non-binding resolutions were finally passed in California (4), Hawaii (4), Massachusetts, Rhode Island (2), Vermont and Wisconsin. Measures that only affected existing Medicaid programs generally were not tracked in this report. See NCSL's
Recent Medicaid Prescription Drug Laws and Strategies for examples of Medicaid changes.

TABLE #1B - 2004 Prescription Drug Legislation by Topic

Prescription Drug Bill Topic Topic
Code States with 2004 legislation
(Underline = passed)

Use of federal 340B discount price program 340B CA, CO, CT, KY, MN, NM, VT, VA

Multi-state or agency bulk purchase Bulk AL, CA, CO, CT, DC, HI, IN, MA, MN, MS, NE, NH, NY, VT, WV

Clearinghouse information CL CO, GA, HI, IL, IA, MA, MS, TN, VA, WV, WI

Discount program & price-related policy D AL, AK, CA, CO, DE, DC, FL, GA, HI, ID, IN, IA, LA, ME, MA, MN, MS, NH, NJ, NM, NY, OH, OK, RI, VT, VA, WA, WV

Relates to generic drugs Generic AL, FL, HI, IN, NH, RI, UT, VT

Regulate drug importation or reimportation Imp AZ, CA, CT, DC, FL, HI, ID, IL, KY, LA, MD, MN, MO, MS, NE, NH, NY, PA, RI, TN, VT, VA, WA, WV, WI

Regulate prescriptions, labels or packaging on retail pharmaceuticals Lab CA, IL, IN, LA, MD, MI, MN, NY, TN, WI

Relates to mail-order of pharmaceuticals Mail CO, GA, IA, ME, MD, MA, MI, NJ, NY, TN, VT

Marketing & advertising Mkt AK, CA, DC, HI, IL, KY, MD, MN, MS, NY, RI, VT, WV
Also see separate NCSL Report at rxads.htm

Medicaid
(partial list; see notes) M AL, CA, CO, DC, ID, ME, MA, MN, MS, NH, NJ, NM, NC, RI, TN, VT, WV, WY
See separate NCSL report at medicaidrx.htm

Medicare Prescription Drug Act of 2003 (MMA), state adjustments & changes MMA AK, CA, CT, FL, HI, IL, IN, IA, ME, MD, MA, MN, MO, NJ, NY, NC, PA, RI, SD, TN, UT, VT, VA, WV, WY
See separate NCSL Medicare Rx report [pdf]

Pharmacy Plus waivers from Medicaid P+ CO, FL, WY

Regulation of pharmaceutical benefit managers PBM CA, CT, DC, FL, IL, IA, ME, MD, MI, MN, MS, NH, NY, SD, VT

Preferred Drug List
(partial list; see notes) PDL CA, CO, CT, FL, HI, ME, MA, NH, VT, WV, WY

Relates to pricing of pharmaceuticals Price GA, HI, ME, NJ, NM, NY, OH, OK, RI, VT, WV, WI

Reuse or recycling of pharmaceuticals Re HI, IN, IA, KY, LA, ME, MO, NE, NM, OK, SD, WI

State Rx Subsidy program S AK, CT, DE, DC, FL, HI, KY, ME, MA, MI, MN, MO, NJ, NY, NC, PA, RI, TN, UT, VT, VA, WV, WI, WY

Study or task force on Rx Study AZ, CA, GA, IN, LA, MA, NH, NJ, NY, VA, VT, WV, WY

Other Rx policy - AL, CA, HI, ID, IA, KS, KY, LA, MD, MI, MS, NE, NJ, NM, NY, VA, WV, WI

Summary Table notes: Bill content and functions may vary widely. Not all topics are categorized in Table #1B. Please use the state Table #2B and bill links below for all details. Bills initially filed in 2003 are summarized on a separate 2003 Table #1A.

2003 legislation, including 82 bills and resolutions signed into law, are available online in the NCSL Report: 2003 State Prescription Drug State Legislation.

TABLE #2B - 2004 Prescription Drug Legislation by State

State/bill/ web link / sponsor
yellow background = enacted or completed Description / excerpts of bill text
Only includes prescription drug bills newly filed for the 2004 state legislative sessions. Bill status may change frequently - check state legislative links below or legislative offices for the most recent actions. Topic
code

AL
HB 156
Rep. Johnson
Would levy the privilege tax on each prescription filled or refilled regardless of whether the prescription was filled for a citizen of Alabama.
(Filed 2/3/04; did not pass by end of session 5/04)| Tax, -

AL
HB 747
Would create the Alabama Prescription Cost Initiative and Board; with authority to negotiate for drug discounts, rebates or cooperatives.
(Filed 4/6/04; favorable committee substitute 4/14/04; no additional action before end of session 5/17/04)| Bulk, D, M

AL
SB 193
Sen. Smitherman
Would require a physician prescribing a medication to prescribe a generic equivalent if available unless the physician notes in the patient's record that the brand name is medically necessary and notes on the prescription to the pharmacist that the brand name medication is medically necessary.
(Filed 2/3/04 and sent to committee; no additional action before end of session 5/17/04)| Generic -

AK
HB 328
Rep. Gara Would allow a pharmacy to advertise that the pharmacy offers a senior prescription drug discount plan under certain conditions. "A pharmacy may participate in the Alaska senior prescription drug discount plan, In order to advertise that the pharmacy is part of the plan, a pharmacy, upon presentation of a valid prescription for a prescribed drug covered under the program and the patient's Medicare card, may not charge a Medicare patient a price for the prescribed drug that exceeds the drug reimbursement rate set by the state for the Medicaid program.
(Filed 5/20/03; no additional action before end of session)| MMA, Mkt

AK
SB 259
Finance Comm.
Would establish the SeniorCare program, that would provide cash assistance and prescription drug benefits as specified as far as practicable under appropriations provided by law. Eligibility: Age 65 or older, not more than 135 percent of the federal poverty level for this state to be eligible for cash assistance under this section or prescription drug benefits; or of more than 135 percent, but not more than 150 percent, of the federal poverty level for this state for prescription drug benefits.
(Filed and sent to committee 1/12/2004; no additional action before end of session)| S

AK
HB 374,
SB 259
Governor
Would create two pharmaceutical assistance programs. 1) $120-per-month cash assistance option or a new $1,600-per-year prescription drug plan that would end when the Medicare benefit goes into effect January 2006. Eligibility for 65 and older with incomes of less than $15,134 a year and liquid assets of less than $4,000. Couple maximum combined income of $20,439 and liquid assets of up to $6,000. 2) An optional reimbursement benefit of $1,000 a year would be available for those up to 150 percent of the federal poverty level, or $16,815 a year for a single person and $22,710 for a couple. Effective date and operational for beneficiaries, April 2004.
Update: The SeniorCare Rx program is being coordinated with the Medicare $600 transitional subsidy, for a benefit described as totaling $2200 per year.
(HB 374 Passed House 2/4/04; Passed Senate 2/19/04; signed by governor as Act 3, 3/5/04)| D, MMA, S

AZ
HM 2001
Rep. McClure
Non-binding resolution would urge the United States Department of Health and Human Services to certify the safety of Canadian drugs for importation.
(Filed 1/14 and sent to committees 1/27/04; failed to pass 2/12/04)| Imp

AZ
H 2555
Rep. Jayne
Would establish a prescription drug price information study committee.
(Filed 1/29/04; did not pass by end of regular session)| Study

AR Arkansas has no regular 2004 session

CA
AB 262
Assm. Chan Would prohibit the sale of patient information from Rx purchases.
(Filed 2/4/03; passed Assembly 1/6/04; amended & passed Senate 22y-15n, 8/25/04; did not pass by end of regular session 8/31/04) -

CA
AB 1957
Assm. Frommer
Requires the State Board of Pharmacy to establish a Web site on or before July 1, 2005, to facilitate the safe purchase by California residents of prescription drugs at reduced prices. Would require the Web site to include price comparisons of prescription drugs, including prices charged by licensed pharmacies in the state and Canadian pharmacies that provide mail order service to the United States that meet certification requirements.
(Favorable committee reports; passed Assembly 5/26/04; passed Senate 21y-13n, 8/26/04; vetoed by governor 9/29/04) | Imp, M

CA
AB 1958
Assm. Frommer
Authorizes the Public Employees' Retirement System (for state and public employees health benefits) to establish or enter into pharmaceutical purchasing consortiums with private or public entities, including other states.
(Filed 2/12/04; passed Assembly 5/26/04; passed Senate 21y-11n, 8/26/04; vetoed by governor 9/29/04) | Bulk

CA
AB 1959
Assm. Chu
Requires the State Auditor to conduct audits of the state's prescription drug procurement and reimbursement practices. The audit report shall include:
   (1) A review of a representative sample of the state's procurement and reimbursement of drugs "to determine whether the state is receiving the best value for the drugs it purchases."
   (2) A comparison of drug costs to the state with drug costs to other appropriate entities such as the federal government, the Canadian government, and private payers.
   (3) A determination of whether the state's procurement and reimbursement practices result in savings from strategies such as negotiated discounts, rebates, and contracts with multistate
purchasing organizations, and whether the strategies selected by the state result in the lowest possible costs. A first report is due May 31, 2005.
(Original language, deleted from final version) Would have authorized the chair and vice chair of specified committees of the Legislature to inspect any state agency contracts for single-source or multiple-source drugs or health benefit plans for employees (including confidential rebate contracts), and required such legislators to maintain the confidentiality of the contracts or amendments to the contract.
(Filed 2/12/04; passed Assembly 5/26/04; passed Senate; signed by governor as Chapter 938, 9/29/04)
Study

Bulk, D, M, price

CA
AB 1960
Assm. Pavley
Defines the term "pharmacy benefits management" (PBM) as negotiating the purchase of dangerous drugs on behalf of specified entities and administering or managing the prescription drug benefit programs of those entities and as an entity that performs pharmacy benefits management. Would also impose on that entity a fiduciary duty to the person employing or contracting with the entity.
(Filed 2/12/04; passed Assembly 5/26/04; passed Senate 23y-19n, 8/25/04; vetoed by governor 9/29/04) | PBM

CA
AB 2125
Assm. Levine
Would require physicians to indicate the patient's diagnosis on each prescription and require the pharmacist to add it to the label unless directed otherwise by the patient.
(Filed 2/18/04, died; did not pass committee 4/20/04, 8/31/04) | Lab

CA
AB 2151
Assm. Jackson
Medi-Cal Reimbursement Rates: Allows a community clinic or free clinic that has a licensed drug dispensary to bill Medi-Cal or Family PACT for drugs purchased through the federal 340B program at the clinic's acquisition cost plus a dispensing fee of up to twelve dollars ($12), or its usual charge made to the general public, whichever is less.
(Filed; passed Assembly and Senate; signed by governor as Chapter 851 of Statutes 2004, 9/29/04). 340B, M

CA
AB 2326
Assm. Corbett

Would support the establishment by the state of an evidence-based prescription drug program for health care consumers and purchasers that identifies preferred drugs and increases public awareness regarding the safe and cost-effective use of drugs.
(Filed 2/12/04; passed Assembly 5/26/04; died; did not pass Senate committee 8/17/04) PDL

CA
AB 2682
Assm. McLeod

Requires the state Board of Pharmacy to adopt regulations governing any person engaged in the wholesale distribution of prescription drugs, which regulations shall implement the same federal regulatory provisions applicable to wholesalers engaged in interstate commerce. Requires all out-of-state wholesalers selling or distributing prescription drugs or devices in California to obtain an out-of-state dangerous drugs and devices distributor's license from the board.
(Filed 2/20/04; passed Assembly 5/18/04; passed Senate 21y-14n, 8/27/04; signed by governor as Chapter 938, 9/29/04) wholesale

CA
AJR. 61
Assm. Ridley Non-binding resolution requests the U.S. Secretary of Health and Human Services to certify to Congress that implementation of provisions of the Medicare Prescription Drug, Improvement and Modernization Act of 2003, permitting the importation of prescription drugs from Canada into the United States will pose no additional risk to the public's health and safety.
(Adopted in Assembly 46y-24n, 4/22/04; adopted in Senate 22y-13n, 7/1/04; chaptered by Secretary of State as Resolution Chapter 111, 7/8/04) Imp, MMA

CA
AJR 62
Assm. Ridley
Non-binding resolution urges Congress to repeal Medicare law prohibitions on federal government negotiating fair prices, and requests members of the state delegation to" sponsor and support legislation to repeal" such language.
(Adopted in Assembly 45y-26n 4/22/04; adopted in Senate 22y-12n, 7/1/04; chaptered by Secretary of State as Resolution Chapter 112, 7/8/04) MMA

CA
SB 1144
Sen. Pres. Burton
Provides that the state General Services Department can purchase pharmaceuticals from authorized Canadian pharmacies or sources, as well as existing in-state sources, for use with state hospitals and prisons. Adds Canada to a required progress report on bulk and discount purchasing due by 2/1/05.
(Favorable report; passed Senate 23y-12n, 5/24/04; passed Assembly 51y-25n, 8/25/04; vetoed by governor 9/29/04; sent to S. unfinished business 10/4/04) Imp, Bulk

CA
SB 1149
Sen. Ortiz
Requires the Board of Pharmacy to collect and publish information concerning suppliers of dangerous drugs that are located and operating outside of the United States that have violated safe shipment, handling, and processing standards.
(Favorable committee report; passed Senate 24y-13n, 6/23/04; passed Assembly 8/27/04; vetoed by governor 9/29/04; sent to S. unfinished business 10/4/04) Imp

CA
SB 1333
Sen. Perata

Authorizes the Department of Health Services to reimburse a pharmacy that provides to a Medi-Cal or AIDS Drug Assistance Program (ADAP) beneficiary a prescription drug that was purchased from a Canadian pharmacy. Provides the formula for determination of such reimbursement.
(Filed 2/18/04; passed Senate 24y-9n; passed Assembly 8/26/04; vetoed by governor 9/29/04; sent to S. unfinished business 10/4/04) Imp, M

CA
SB 1426
Sen. Ducheny
Requires the department to adopt policies and procedures for drug utilization that will optimize efficacy and cost-efficiency within the correctional system, in coordination with the Department of General Services' prescription drug bulk purchasing program, and to adopt best practices standards for pharmaceuticals established by recognized professional health care organizations, as specified.
(Filed 2/19/04; passed Senate 35y0n, 5/3/04; passed Assembly 77y-0n, 8/12/04; became law as Chapter 383 of 2004, 8/30/04) | Bulk, Study

CA
SB 1427
Sen. Ackerman
Would enact that any person who initially introduces into commerce a drug that is counterfeit is guilty of a felony, punishable by imprisonment in the state prison, if that action results in the death of a human being.
(Filed 2/16/04; did not pass committee 3/4/04; died 8/31/04) | Counterfeit

CA
SB 1765
Sen. Sher

Requires pharmaceutical companies to adopt a Comprehensive Compliance Program that is in accordance with a related federal government publication, to include policies on marketing interactions with health care professionals and limits on gifts and incentives to medical or health professionals, incluing "specific annual dollar limit on gifts, promotional materials, or items or activities that the pharmaceutical company may give or otherwise provide to an individual
medical or health care professional. '
(Initial language, deleted from final bill) Would prohibit a pharmaceutical or drug manufacturer from giving gifts to medical or health professionals, with exceptions for drug samples, educational materials, low-cost items primarily associated with a health care professional's practice, and up to 4 meals per year.
(Filed 2/20/04; passed Senate 21y-14n, 4/22/04; amended & passed Assembly 8/23/04; signed by governor as Chapter 927, 9/29/04) | Mkt

CA
SB 1913
Committee on Business and Professions
Prohibits a manufacturer of pharmaceuticals from operating without employing sufficient, qualified supervision to adequately safeguard and protect the public health. Other provisions affect pharmacist practices and personnel.
(Filed 3/17/04; passed Senate 5/27/04; amended and passed Assembly 8/23/04; signed by governor as Chapter 695, 9/22/04) -

CA
SJR 24
Sen. Ortiz
Requests or memorializes the President and U.S. Congress to recognize the problems caused by direct-to-consumer advertising of prescription drugs by pharmaceutical companies and to take specified actions in the regulation of consumer advertising of prescription drugs.
(Filed 2/25/04; adopted by Senate 3/30/04; amended and adopted by Assembly 49y-25n, 7/1/04; chaptered by Secretary of State as Resolution Chapter 139 of 2004, 8/12/04) Mkt

CA
SJR 25
Sen. Ortiz
Non-binding resolution, requests the U.S. Congress and the President to enact and sign into law specified revisions to the Medicare Prescription Drug Improvement and Modernization Act of 2003 including: Index increases in beneficiaries' premiums, deductibles, and cost sharing limits to increases in Social Security benefits or changes in income for beneficiaries; give authority to the Secretary of the United States Department of Health and Human Services to negotiate the prices of drugs to be made available to beneficiaries under the Act; to direct the Secretary to work with states on establishing workable systems to enable beneficiaries and others to safely import drugs from Canada; to allow states to receive matching funds if they choose to maintain the existing level of drug coverage for beneficiaries who are dually eligible for Medicare and Medicaid
(Filed 3/8/04; adopted by Senate 3/30/04; adopted by Assembly 47y-28n, 8/18/04; chaptered by Secretary of State as Resolution Chapter 168, 9/1/04) Imp,
MMA

CO
SB 92
Tapia
Would establish the Colorado Prescription Drug Discount Program to provide a prescription drug discount to eligible persons at a rate similar to the Medicaid rate, or not more than 10percent above that rate. Would specify eligibility as residents with income up to 200percent of federal poverty not eligible for Medicaid. Would require the program to charge an annual program enrollment fee of $25. Would specify that implementation requires receipt of federal approval, with an application to be prepared only if the state receives gifts, grants, or donations sufficient to provide for the state's administrative costs of submitting the application for federal approval.
(Filed 1/12/04; died in committee at end of regular session 5/5/04)| D, M, P+

CO
SB 184
Rep. S. Johnson
Would create a preferred drug list for Medicaid.
(Filed 1/13/04; died in committee at end of regular session 5/5/04)| M, PDL

CO
HB 1128
Rep. Salazar
Would establish the Colorado bulk purchasing council, with all state agencies authorized to participate.
(Filed 1/13/04; died in committee at end of regular session 5/5/04)| Bulk

CO
HB 1238
Rep. McFadyen

Would address access to maintenance drugs from prescription drug outlets for covered persons. Makes it an unfair method of competition and unfair or deceptive act or practice in the business of insurance to refuse to reimburse a retail prescription drug outlet, differentiate between mail order and retail prescription drug outlets, or otherwise restrict or limit such outlets in violation of the law.
(Filed 1/28/04; died in committee at end of regular session 5/5/04)| Mail

CO
HB 1268
Rep. Pommer
Would create a Colorado Rx clearinghouse to provide residents with access through the free and discount patient assistance programs sponsored by pharmaceutical drug companies. The state could charge a fee for such services, but would not purchase drugs for residents.
(Filed 1/28/04; died in committee 2/12/04)| CL

CO
HJR 1070
Rep. Frangas
Would encourage all health care facilities that may qualify as covered entities under the federal 340B drug pricing program to maximize the utilization of the program, and have all state agencies explore all avenues with 340B "to receive maximum state budget savings."
(Filed and sent to committee 4/15/04; no further action before end of session 5/5/04)| 340B

CT
HB 5008
Comm. on Aging

Provides for replacement prescriptions if dispensed products are lost by or stolen from a ConnPACE enrollee; requires an affidavit describing circumstances; and allows copayments to be waived.
(Filed 2/4/04 passed House and Senate 4/28/04; signed by governor as Act 04-104, 5/21/04)
S

CT
HB 5026, 5027, 5029, 5085, 5088, 5093, 5192, 5195, 5282, 5283, 5284, 5336
SB 2, 5, 9, 13, 15, 24, 89, 90, 199, 200
Would change various parts of the ConnPACE pharmaceutical subsidy program including: elimination or change of the estate recovery provision enacted in 2003, allow for replacement prescriptions, change the asset test, change cost sharing, change supply limits for maintenance drugs, and others.
(Filed 1/04; did not pass by end of regular session 5/5/04)| S

CT
HB 5040
Gov. Budget/Rep. Ward
Would direct federally qualified health centers (FQHCs) to enroll in 340B, but the language was stricken from an amended version.
(Filed 2/04; Rx language deleted and did not pass) 340B

CT
HB 5617
Human Services Committee
Would add a health care and pharmaceutical component to the state's general assistance program through federally qualified health centers.
(Filed 3/3/04; did not pass by end of regular session 5/5/04)| S, 340B

CT
SB 8
Rep. Bruce Zalaski
Would require the CT Commissioner of Social Services to establish a procedure by which ConnPACE participants may obtain covered prescription drugs from Canadian pharmacies and waive the copayment charge for such drugs. Also addresses Medicare coordination of benefits and auto enrollment.
(Filed and sent to committee, 2/4/04; passed Senate 4/21/04; passed House 4/22/04; signed by governor 4/28/04 as Public Act 04-101) Imp, MMA, S

CT
SB 111

Would regulate pharmacy benefit management companies, requiring an annual license from the Insurance Commission, a license to practice pharmacy, financial statements, approval of contracts, and cannot discriminate when contracting with pharmacies on the basis of copayments or days of supply.
(Filed 2/11/04; passed Senate 4/22/04; did not pass by end of regular session 5/5/04)| PBM

CT
SB 295
Program Review and Investigations Committee
Would make changes to the state's preferred drug list process for Medicaid and ConnPACE.
(Filed 2/18/04; did not pass by end of regular session 5/5/04)| PDL, S

CT
SB 351
Public Health Committee
Would require the development of a comprehensive preferred drug list, rather than one limited to three classes of drugs.
(Filed 2/19/04; did not pass by end of regular session 5/5/04)| PDL

CT
SB 472
Public Health Committee
Would develop a plan for unified prescription purchasing for all state purchases through the University of Connecticut Health Center, an expanded preferred drug list and the purchase of state-funded prescription drugs from other jurisdictions.
(Filed 2/25/04; did not pass by end of regular session 5/5/04)| PDL, bulk, Imp, 340B

CT
SB 609
Appropriations Committee
Would seek to maximize the amount of federal funding for which the state is eligible under new provisions of federal law related to Medicare, Medicaid, DSH payments and employer- sponsored retirement plans providing prescription benefits.
(Filed 3/11/04; did not pass by end of regular session 5/5/04)| MMA

DE
SB 320
Sen. Cook
FY05 Budget (Sec. 162) requires an Rx manufacturers' rebate program for all non-Medicaid state pharmaceutical programs, based on the full Medicaid rebate structure. Appropriates $6.9 million for the senior pharmaceutical Assistance Program, funded with Tobacco Settlement funds.
(Passed Senate 6/22/04; passed House 6/30/04) D, S

DC
B15-569
Councilmember Catania

Enacts the Rx Access Act of 2003, requiring the Dept. of Health to run an AccessRx subsidy program for low-income elderly District residents (eligibility: age 62 or older with household income not more than 200 percent of federal poverty), with enrollees to pay 20 percent of the cost of prescriptions. Also establishes discount prices for qualified uninsured residents (eligibility: any District resident with household income not more than 350 percent of federal poverty, not enrolled in any insurance program) . Requires drug manufacturers to enter into rebate agreements for products sold to publicly funded programs, with public disclosure and possible prior authorization restrictions for products lacking rebate agreements. Includes requirements for disclosure and reporting of Rx marketing costs by manufacturers; also permits negotiations with other states or jurisdictions for bulk purchasing. Also provides that the Department "shall investigate purchases from outside the U.S. Also regulates PBMs, including establishing a legal "fiduciary duty" to any covered entity or customer, transparent business practices, pass through of payments and disclosure of rebates from manufacturers.
(Filed 11/4/03; Passed City Council 3/24/04; signed by mayor as Act 15-410) |
This law is being challenged in court in a case named "Biotechnology Industry Organization and Pharmaceutical Research and Manufacturers of America v. District of Columbia, U.S. Court of Appeals for the Federal Circuit No. 2006-1593" it was pending as of 11/06. 18 consumer groups filed an amici brief on 11/6/06) Bulk, D, Imp, M, Mkt, PBM, S

FL
HB 541
Rep. Justice

Non-binding memorial, would urge the Congress of the United States to support the Medicare Prescription Drug Savings Act of 2003 to allow direct negotiation of prescription drug prices with pharmaceutical companies.
(Filed 1/20/04; died in committee 4/30/04)| MMA

FL
HB 1347
S 3042
Rep. Roberson
Would define role and responsibilities of PBMs and would allow for dispensation and purchase of Canadian prescription medicines if federally approved.
(Filed 2/25/04; died in committee 4/30/04)| PBM, Imp

FL
HB 1837 |
Appropriations
Budget bill provides that 1) if the federal Centers for Medicare and Medicaid approve LifeSaver Rx subsidy program waiver during the 2004-05 year, the program may apply to increase the state share of spending to cover persons with higher incomes.
2) Section 110.12315  establishes a redefined State Employees Prescription drug program, with increased copays, from $10 to $80, and required use of a preferred drug list (PDL)
(Filed 3/28/04; passed House 4/1/04; passed Senate 4/2/04; signed by governor as Chapter 2004-269, 5/28/04)| copay, PDL, S, P+

FL
HB 1843 |
Appropriations
Budget bill reauthorizes the FL Lifesaver Rx program, "in the absense of federal approval from CMS," to provide benefits to residents up to 120 percent of federal poverty, with subsidies up to $160 per month. The program is to apply "cost controls applied to other Medicaid prescribed drug benefits" and to include copayments of $2 for generics, $5 for products on hte preferred drug list (PDL) and $15 for non-PDL drugs.
(Filed 3/04; passed House and Senate, 5/04; signed by governor as Chapter 2004-270, 5/28/04)| PDL, P+, S

FL
SB 2542
Sen. Siplin

Would allow patients to participate in health care decisions, select their physician or other health care provider, and choose between generic or brand-name prescription medications.
(Filed 3/2/04; died in committee 4/30/04)| Generic

GA
HB 935
Rep. Harrell
Would create an advisory group on seniors and prescription drug costs.
(Filed 4/8/03, passed House 3/15/04; did not pass by end of regular session 4/04)| Study

GA
HB 1061
Rep. Stephens
HB 1220
Rep. Stephens
Would provide a process schedule of maximum manufacturer prices for patented prescription drugs and certain other drugs sold in the state
(Filed 1/5/04; did not pass by end of regular session 4/04)| D, Price

GA
HB 1442
Rep. Gardner

Would require pharmacist to ensure that the total pharmacy reimbursement cost of a prescription drug is printed on the receipt that the patient receives upon the purchase of such prescription drug dispensed.
(Filed 2/12/04; Committee reported favorably 2/25/04; did not pass by end of regular session 4/04)| D, Price

GA
HB 1478
Rep. Dodson
Would permit a health maintenance organization to utilize a licensed Georgia pharmacy that is owned and operated by such health maintenance organization to distribute refills of prescription drugs by mail or other common carrier for its enrollees only.
(Filed 2/16/04; did not pass by end of regular session 4/04)| Mail

GA
HB 1692
Rep. Hill
Would establish a drug repository program to accept and dispense donated prescription drugs.
(Filed 3/4/04; did not pass by end of regular session 4/04)| CL

GA
SB 543
Sen. Balfour
Among other things, would allow a pharmacist to use mail order to fill prescriptions for customers.
(Filed 2/20/04; did not pass by end of regular session 4/04)| Mail

GA
SB 544
Sen. Balfour
Would allow health maintenance organizations to utilize Georgia based pharmacies to provide mail order prescription services to its members.
(Filed 2/20/04; did not pass by end of regular session 4/04)| Mail

HI
HB 1920
Rep. Takumi
Would establish ethical marketing requirement for prescription drugs. Requires manufacturers and labelers who sell prescription drugs in Hawaii to disclose the value, nature, and purpose of gifts and other economic benefits given doctors and other health care providers in connection with detailing, marketing, or promotions.
(Filed 1/23/04; died at end of regular session 5/5/04)| Mkt

HI
HB 1921
Rep. Takumi
Would direct the governor and agencies to develop, operate, and maintain a website to assist Hawaii residents in purchasing prescription drugs from Canada.
(Filed 1/23/04; died at end of regular session 5/5/04)| Imp.

HI
HB 2005 final
Rep. Say

Establishes a prescription drug return and reuse program, and authorizes donated drug repositories. Authorizes pharmacists to receive and redistribute previously dispensed drugs under regulated circumstances.
[House version; deleted in signed version] Would change the name of the Rx program to Rx plus; adds new definitions of "covered drugs", "participating retail pharmacy", and "qualified resident"; establishes requirements to determine qualified residents; requires department of human services to conduct ongoing quality assurance activities; clarifies consequences applicable to nonparticipating manufacturers. (The program is scheduled to be operational July 1, 2004- see SB 3237 below for final discount law)
(Filed 1/23/04; passed House 3/2/04; passed Senate 4/13; signed by governor as Act 190, 7/9/04
D, MMA, Re

HI
SB 2090
Sen. Baker
Would establish the prescription drug repository program to receive and dispense donated prescription drugs to needy persons.
(Filed 1/21/04; passed Senate 3/9/04; died in House 5/5/04)| Re

HI
HB 2096
Rep. Arakaki
Would establish the prescription drug repository program to receive and dispense donated prescription drugs to needy persons.
(Filed 1/23/04; ; died at end of regular session 5/5/04)| Re

HI
HB 2161
Rep. Schatz
Would establish a refundable income tax credit of 10 percent of the cost of prescription drugs for residents whose income is 200 percent of the federal poverty level or less.
(Filed 1/26/04; ; died at end of regular session 5/5/04)| S

HI
HB 2460
Rep. Say
SB 2935
Sen. Bunda
Would amend the Hawaii Rx program based on the U.S. Supreme Court's ruling on the Maine Rx program on which Hawaii Rx is modeled, to: (1) address the concerns of the Centers for Medicare and Medicaid Services to protect access of Medicaid clients to the prescription drugs they need; (2) prevent loss of prescription of drug benefits to employees covered by employer-sponsored drug benefit plans; (3) address the concerns of pharmacies and drug manufacturers; (4) adjust the manufacturers' the rebate; and (5) rename the program Hawaii Rx Plus.
(Filed 1/26/04; died at end of regular session 5/5/04)| D, MMA

HI
HB 2475,
SB 2950

Makes U.S. FDA-approved, therapeutically equivalent generic drug products substitutable upon approval by the director of health.
(SB 2950 filed 1/26/04; passed Senate 3/9/04; passed House 4/8/04; signed by governor as Act 24, 4/29/04)| Generic

HI
HB 2707
Rep. Oshiro
Would establish the Prescription Drug Cost Containment Program to reduce the costs of prescription drugs for Hawaii residents, while maintaining high quality in prescription drug therapies.
(Filed 1/27/04; died at end of regular session 5/5/04)| PDL, CL, Bulk

HI
HB 2987
Rep. Hiraki
Would adopt income limits and other eligibility requirements for state drug prescription program. Clarifies consequences of manufacturer nonparticipation. Requires rebates from participating manufacturers. Establishes committee to recommend drugs for preferred and nonpreferred drug lists.
(Filed 1/28/04; died at end of regular session 5/5/04)| D, Rebate, PDL

HI
HR 54
HCR 81
Rep. Say
Non-binding resolutions, would urge members of Congress to "to promote the repeal of the Medicare Modernization Act and work to enact legislation that will ensure universal access to a single-payer uniform health insurance program with subsidies for needy seniors and establish a prescription drug plan as part of the traditional Medicare program designed to lower the cost of prescription drugs for everyone through bulk purchasing" or to work for reform of high premiums and restricted asset tests.
(HR 54 adopted by House 4/13/04;
HCR 81 passed House; did not pass Senate 5/5/04) MMA

HI
SR 24,
HR80,
SCR 56
Sen. Menor
Non-binding resolution, would urge the president and congress to repeal the ban against federal negotiating of price reductions for prescription drugs.
(SR 24- Filed 3/15/04; resolution adopted by Senate 4/8/04; sent to Congress 4/30/04)|
(SCR56 adopted by Senate 4/8/04; adopted by House 4/29/04; sent to Congress 5/10/04)| MMA

HI
SB 2648
Sen. Chun
Would require the department of human services to enter into prescription drug purchasing alliances with other states and other public and private entities.
(Filed 1/26/04; died at end of regular session 5/5/04)| Bulk

HI
HCR 70, HCR 80, HCR 192, HR 134, SCR 125, SR 63
Non-binding resolutions generally would urge the Congress and President to allow prescription drugs to be imported from Canada.
(Filed 1/04; died at end of regular session 5/5/04
Imp

HI
SB 2684
Sen. Hooser
Would authorize the Department of Public Safety to purchase from Canada maintenance prescription drugs equivalent to FDA-approved drugs for its inmate population.
(Filed 1/26/04; died at end of regular session 5/5/04)| Imp

HI
HR 47,
HCR 70,
SCR 27
Non-binding resolutions urge support for Federal legislation authorizing the importation of prescription drugs.
(SCR 27 Filed 2/10/04; adopted by Senate and House 4/30/04; certified and sent to Congress 5/10/04)
(HR 47 filed 3/15/04; adopted by House 4/7/04; certified and sent to Congress 5/14/04)
(HCR 70 adopted by House; died in Senate 5/5/04)| Imp

HI
SB 3045
Sen. Hooser
Would authorize the state and the Hawaii Rx program to purchase prescription drugs from and negotiate manufacturer's rebates with Canadian pharmaceutical companies for the benefit of non-Medicaid eligible persons and government program beneficiaries.
(Filed 1/28/04; ; died at end of regular session 5/5/04)| Imp

HI
SB 3237 |
Sen. Menor
Adopts income limits and other eligibility requirements for state drug prescription program, renamed Hawaii Rx Plus. Clarifies consequences of manufacturer nonparticipation. Requires rebates from participating manufacturers. Establishes committee to recommend drugs for preferred and nonpreferred drug lists.
(Filed 1/28/04; passed Senate 3/2/04; passed House 4/5/04; signed by governor as Act 47, 5/3/04) | D, Rebates, PDL

ID
HJM 016
Rep. Shepard
Non-binding resolution, would urge Congress to adopt legislation to allow people of the United States and state and local government entities to legally purchase prescription drugs in Canada.
(Filed 2/11/04; did not pass by end of session 4/12/04) Imp

ID
SB 1419
Judiciary and Rules Committee
Would establish the Idaho Prescription Drug Program.
(Filed 3/1/04; did not pass by end of session 4/12/04) D, Rebate

IL
HB 4233
Rep. Franks
Would require drug companies to disclose the nature and value of any gifts, fees, payments and other economic benefits related to promotions by a pharmaceutical company to doctors and pharmacists.
(Filed and sent to committee, 1/30/04; did not pass committee 3/23/04; did not pass by end of session 12/04) Mkt

IL
HB 6787
Rep. Mulligan
Would provide that if the State allows or provides incentives for State employees or State retirees to purchase prescription drugs from a pharmacist or other distributor located in a country other than the United States, then the Department of Public Health must develop and implement a certification program for those foreign drugs.
(Filed and sent to committee 2/9/04; did not pass by end of session 12/04) | Imp

IL
HB 6851
Rep. Coulson
Would provide that, in the event that the current pharmacy assistance program ceases to provide benefits and the federal government creates a Medicare prescription drug benefit, the Department shall develop a new supplemental coverage program to help cover out-of- pocket expenses "including premiums, deductibles, co-payments and any other expenses required by enrollees" in the Medicare prescription drug benefit program. Provides guidelines for coverage under and eligibility for the program.
(Filed and sent to committee 2/9/04; did not pass by end of session 12/04) | MMA

IL
HB 6871
Would establish regulation of pharmacy benefits managers by requiring: a certificate of authority from the Director of Insurance and Pharmacy Board, filing and state approval of contracts, and financial examination by the state.
(Filed and sent to committee 2/9/04; did not pass by end of session 12/04) | PBM

IL
HJR 56
Rep. Franks
Non-binding resolution, would urge Congress to pass legislation allowing purchase of prescription drugs in Canada.
(Filed and sent to committees 2/4/04 & 5/11/04; did not pass by end of session 12/04) | Imp

IL
SB 2253
Sen. Demuzio

Amends the Pharmacy Practice Act, by adding the activities of "preparation, computer entry and verification of medication orders, medical devices and prescriptions" as steps regulated under pharmaceutical dispensing.
(Passed Senate 3/25/04; passed House 5/26/04; signed by governor as Public Act 93-1075, 1/18/05)
Lab, -

IL
SB 2608
Sen. Obama
Would require the Senior Health Assistance Program Clearinghouse to provide information concerning the purchase of prescription drugs from sources outside Illinois. Also would require the governor to request the U.S. Department of Health and Human Services to license the Senior Health Assistance Program to act as an agent for Illinois senior citizens.
(Filed and sent to committees 2/27/04; did not pass by end of session 12/04) | Imp, CL

IL
SB 2609
Sen. Obama
Would expand the definition of "mail-order pharmacy" and requirements concerning registration of mail-order pharmacies to include pharmacies located outside of the US, including Canada.
(Filed and sent to committee 2/4/04; did not pass by end of session 12/04) | Imp

IN
HB 1085
Rep. Reske
Among other things, would establish a regional drug repository program to distribute donated drugs to nonprofit health clinics.
(Filed 1/13/04; did not pass by end of session 3/04) | Re

IN
HB 1251
Rep. Becker
Establishes the Indiana Prescription Drug Advisory Committee, which is required to "make program design recommendations" to coordinate the Indiana drug subsidy program with the federal Medicare law... to ensure that the program does not duplicate benefits." The committee must report before July 1, 2004 for program changes related to Medicare discount program, and September 1 2004 for changes related to the part D subsidy program.
Also establishes a Regional Drug Repository Program to allow return and reuse of unused medications by pharmacists, hospitals, health care facilities or practitioners. Also expands regulation of protocols concerning the adjustment of a patient's drug regimen to nursing homes
(Filed 1/20/04; Passed House 2/5/04 and Senate 2/19/04; signed by governor as Public Law 75, 3/17/04) MMA, Re

IN
HB 1265
Rep. Kersey
Requires the state personnel department to establish a bulk prescription drug purchasing program to negotiate terms related to the purchase of prescription drugs; requires participation by certain entities and allows participation by other certain entities; authorizes the state to enter into multi-state prescription drug bulk purchasing agreements.
(Filed 1/15/04; passed House 2/5/04; passed Senate 2/24/04; signed by governor as Public Law 50, 3/16/04) Bulk

IN
HB 1363
Rep. Messer
Would require the board of pharmacy to establish procedures under which pharmacies may return expired drugs to drug wholesalers and manufacturers; prohibits a pharmacist from dispensing a prescription drug unless the wholesaler or manufacturer of the drug has a procedure for the return of expired drugs that complies with procedures established by the board of pharmacy.
(Filed 1/20/04; did not pass by end of session 3/04) | Re

IN
HR 59
Rep. Brown
Would urge the health finance commission to look into generic drug pricing.
(Filed, adopted by House 3/1/04) Generic, Study

IN
SB 73

Sen. Breaux
Would allow a pharmacy or pharmacist to donate unused medication of a Medicaid recipient and would make provisions regarding the Regional Drug Depository Program.
(Filed 12/2/03; did not pass by end of session 3/04) | Re

IN
SB 285
Sen. Ford
Would mandate that a prescription label must include a statement of the purpose or symptom for which the drug is prescribed if the practitioner directs that the statement is to be included; provides that a practitioner is not liable for failing to inform a patient that the patient has the option to have the purpose or symptom for which the drug is prescribed on the label.
(Filed 1/8/04; passed Senate 1/27/04; did not pass House by end of session 3/04) | Lab

IN
SB 424
Sen. Dillon
Would require the secretary of family and social services to establish a prescription drug card program through which negotiated benefits related to the purchase of a prescription drug are available to certain residents.
(Filed 1/12/04; did not pass by end of session 3/04) | D

IN
SB 497
Sen. Simpson
Would require the state personnel department to establish an aggregate prescription drug purchasing program to negotiate terms related to the purchase of prescription drugs; requires participation by certain entities and allows participation by certain other entities; authorizes the state to enter into multi-state prescription drug aggregate purchasing agreements; requires the budget agency to report to the budget committee on participation.
(Filed 1/13/04; passed Senate 2/4/04; did not pass by end of session 3/04) | Bulk

IA
HF 2191
Rep. Murphy
Would establish a cancer drug repository program.
(Filed 2/9/04; ; did not pass by end of regular session 4/20/04) | Re

IA
HF 2507,
HF 2216,
SF 2229
Rep. Heaton
Would establish a prescription drug assistance program and clearinghouse for patient assistance program information.
(Filed 2/11/04 & 3/8/04; did not pass by end of regular session 4/20/04; see HF 2554 below) | CL

IA
HF 2554
Rep. Heaton

Establishes a prescription drug assistance clearinghouse for patient information. It requires manufacturers doing business with the state to report the details of their patient assistance programs. Requests approval for federal funding, with a conditional approriation of $250,000 if federal funds are not acquired by Oct. 1, 2004.
(Passed House 4/4/04; passed Senate 4/13/04; sent to governor; vetoed by governor as unnecessary & duplicative of federal efforts, 5/14/04)| CL, MMA

IA
HSB 620
Would regulate the sale or distribution of prescription drugs via the Internet or electronic mail, and providing penalties.
(Filed 2/9/04 and sent to committee; did not pass by end of regular session 4/20/04) | Mail, Internet

IA
HCR 119
Human Resources
Would establish a committee to recommend developing a drug repository program.
(Filed 3/9/04; did not pass by end of regular session 4/20/04) | Re

IA
SF 2016
Sen. Johnson
Would establish a prescription drug assistance program by the commissioner of insurance including a contingent appropriation.
(Filed 1/21/04 and sent to committee 1/26/04; did not pass by end of regular session 4/20/04) | D, CL

IA
HF 496,
SF 2283
State Gov't Comm.
Would regulate pharmacy benefit managers, including licensing, annual reports and a disclosure statement to PBM enrollees.
(Filed 3/8/04; did not pass by end of regular session 4/20/04) | PBM

IA
SR 110
Sen. Ragan
Non-binding resolution would encourage the expansion of the Iowa Priority Prescription Savings Program.
(Filed 2/4/04 ; did not pass by end of regular session 4/20/04) | D

KS
SB 542
Committee on Ways and Means
Would prohibit the use of social security numbers (SSN) on health insurance and prescription drug cards.
(Filed 2/2/04; passed Senate 3/11/04; did not pass by end of session 5/28/04) | -

KY
HJR 38
Rep. Nunn
Would direct the Cabinet for Health Services to study the expansion of the federal 340B prescription drug discount program; including a report to Legislature by October 30, 2004
(Filed1/7/04 and sent to committee) 340B

KY
HCR 59
Rep. Cherry
Non-binding resolution would urge the U.S. Congress and the Dept for Health and Human Services to limit or ban direct to the consumer advertising of prescription drugs.
(Filed 1/8/04 and sent to committee) Mkt

KY
HB 86
Rep. Burch
Charitable Drug Program: Require the Board of Pharmacy and Department for Public Health to jointly establish a plan for a drug repository program to accept and dispense prescription drugs donated for the purpose of being dispensed to individuals who meet eligibility standards.
(Filed 1/6/04 and sent to committee) Re

KY
HB 641
Rep. Pasley
Would provide a tax credit for the cost of prescription drugs.
(Filed 1/27/04 and sent to committee) S, Tax

KY
SS-SB 7
(Special Session) Would propose to establish a program to allow public employees and the Medicaid program to purchase prescription drugs from Canada, as part of reform of state employee health plan. Would request a federal waiver whre needed.
(Filed for special session of 10/7/04; did not pass by end of session) Imp, M

KY
SB 180
Sen. Roeding
Would define "counterfeit prescription drug" and make it illegal to sell, possess, distribute or facilitate distribution of them.
(Filed and sent to committee 2/17/04) counter-
feit -

KY
SB 255
Sen. Denton
Would allow manufacturer to distribute anticonvulsants that are controlled substances to physicians though patient assistance programs.
(Filed and sent to committee 3/2/04) -

LA
HB 318
Rep. Hutter
Would require that the symptom or medical condition for a prescription be indicated on the label or not, if the patient desires.
(Filed 3/16/04; did not pass committee 5/26/04) Lab

LA
HB 894
Rep. Dorsey
Creates the crime of illegal importation of prescription drugs.
(Filed 3/19/04; did not pass by end of '04 session, 6/21/04)| Imp.

LA
HB 1036
Rep. Dorsey
Would provide for definitions and penalties for unfair and deceptive trade practices relating to the sale of certain prescription drugs.
(Filed 3/19/04; ; did not pass by end of '04 session, 6/21/04)| -

LA
HB 1252
Rep. Futrell
Would create the Prescription Drug Advisory Commission to study access to and pricing of prescription drugs.
(Filed 3/19/04; ; did not pass by end of '04 session, 6/21/04)| Study

LA
HB 1402
Rep. Walker
Allows for re-use of prescription drugs from returns, exchanges and donations with certain conditions. Effective date August 15, 2004.
(Filed 3/19/04; passed House and Senate; signed by governor as Act 811, 7/12/04) Re

LA
SB 59
Rep. Fields
Proposed law would enact the Fair Market Drug Pricing Act. Would allow the secretary of DHH to negotiate discount prices or rebates for prescription drugs from drug manufacturers and labelers. Would establish the Rx Card program in accordance with federal law and allow for the secretary of DHH to adopt rules requiring disclosure of the amount of savings provided as a result of the Rx Card program.
(Filed 3/10/04; ; did not pass by end of '04 session, 6/21/04)| D

ME
LD 1713/SB 645
Sen. Brennan
Non-binding Senate Resolve would establish a commission to study access to prescription medication for persons with mental illness.
(Filed and sent to committee 1/7/04; did not pass in committee 3/22/04)| M, PDL

ME
LD 1720/SB 653
Sen. Treat Would "ensure the lowest-priced prescription drugs for Maine seniors."
(Filed and sent to committee 1/7/04; did not pass in committee 3/31/04)| D

ME
LD 1747/HB 1269
Rep. Craven
Would modify the Medicaid Drug Rebate and Elderly Low-Cost Drug Program by authorizing the state to establish enrollee copayments of $2 for those in the catastrophic part of the state subsidy program.
(Filed and sent to committee 1/7/04; passed House and Senate 3/31/04; signed by governor as Chapter 611, 4/9/04)| S, M

ME
LD 1811/H 1333
Rep. Dudley Non-binding resolve, would provide that the Department of Human Services should adopt rules for the MaineCare program to provide access to certain HIV and AIDS drugs without requiring completion of a prior authorization process.
(Filed 1/7/04; died in committee 3/2/04)| M, PDL

ME
LD 1826
Sen. Bromley

Would "Encourage the Proper Disposal of Expired Pharmaceuticals" by return of unsused prescription drugs in a safe and secure manner by mail to a central facility. It does not provide for reuse of such drugs.
(Filed 1/7/04; unfinished; did not pass 4/1/04)| Re

ME
LD 1828
Rep. Brannigan
FY05 budget requires a Medicare beneficiary to use the Medicare drug discount card before using a state sponsored discount program for a pharmaceutical purchase.
(Filed 1/20/04; passed House and Senate on 1/30/04; signed by governor as Chapter 513 on 1/30/04) | MMA

ME
LD 1890/S 736
Sen. Treat
Would require that drug manufacturers doing business in the State report and certify to the Department of Human Services, for each of their drugs, the actual average wholesale price and the wholesale acquisition cost and the average manufacturer price and the best price as defined by federal law.
(Filed 2/26/04; passed House 4/14/04; passed Senate 4/15/04; signed by governor as Chapter 667 on 4/26/04)| M, D, price

ME
LD1919/H 1420
Rep. Brannigan
FY05 Budget allocates $42.9 million funds for drug rebates in the MaineCare program "in order to properly reflect nonmatched MaineCare expenditures. "(i.e. no federal funds). Also authorizes a voluntary mail-order program for Medicaid and state-only Rx programs.
(Filed 3/16/04; passed House and Senate 4/16/04 & 4/28/04; signed by governor as Chapter 673, 4/29/04)| M, Mail, S

MD
HB 116
Del. Costa
Would require the Maryland Health Care Commission to require that a pharmacy discount card option be included in the minimum benefits allowed to be offered in the Comprehensive Standard Health Benefit Plan offered in the small group insurance market; would establish the amount of specified co-payments and deductibles.
(Filed and sent to committee, 1/16/04; withdrawn, died 2/16/04)| Copay

MD
HB 344
Del. Hammon,
SB 798
Sen. Middleton
Would repeal a prohibition against health insurance policies or contracts from imposing a co-payment or deductible on the use of a community pharmacy that is not imposed on the services of a mail order pharmacy; would prohibit specified health insurers from requiring use of mail order pharmacies.
(Filed and sent to committees, 1/28/04, 2/16/04; did not pass by end of regular session, 4/12/04) | Mail, Copay

MD
HB 397
Del. Goldwater
Would require pharmacy benefits managers (PBMs) to register with the secretary of Health and Mental Hygiene; requires an applicant to file an application, submit required documents, and pay an application fee; authorizes the secretary to suspend or revoke a registration or deny an application under specified circumstances.
(Filed 1/29/04; passed House 3/19/04; did not pass Senate 4/9/04) | PBM

MD
HB 433
Del. Boutin
Require prescribers to print or type written prescriptions in a legible manner.
(Filed 1/29/04; passed House 3/12/04, passed Senate 4/4/04; signed by governor as Chapter 503, 5/26/04)| Lab

MD
HB 519
Del. Boutin
Would require a pharmaceutical manufacturing company to disclose marketing information; requires the state Pharmacy Board to report annually on the disclosures; requires marketers to register with the Board, pay a fee, and certify adherence to a specified code of ethics before practicing pharmaceutical marketing in the state.
(Filed 1/29/04; did not pass by end of regular session, 4/12/04) | Mkt

MD
HB 840
Del. Rudolph
Would require a pharmacy benefits manager to perform in the interest of specified persons entitled to specified health benefits; requires pharmacy benefits managers to provide specified information to members or carriers.
(Filed and sent to committee, 2/9/04; did not pass by end of regular session, 4/12/04) | PBM

MD
HB1023
Del. Rosenberg,
SB 614
Sen. Hollinger
Prohibits the state from modifying prescription coverage in the State Employee Health Program as a result of the federal Medicare Act without approval of the General Assembly.
(HB 1023 died in committee 3/22/04)|
(Filed 2/12/04; SB 614 passed Senate, 3/25/04; passed House 4/6/04; signed by governor as Chapter 296, 5/11/04)| MMA

MD
HB 1271
Del. Hurson
SB 715
Sen. Hollinger
Would develop a rotating loan program to assist federally qualified health centers to obtain 340B drug discounts.
(HB 1271 passed House 4/2/04, failed to pass Senate 4/11/04)|
(SB 715 Filed 2/6/04; died in Senate committee 4/04)| 340B

MD
SB 167
Sen. Pinsky
Would require the Secretary of Health and Mental Hygiene, in coordination with the Secretary of Budget and Management, to implement a Canadian Mail Order Plan for prescription drugs; requires the Canadian Mail Order Plan to provide prescription drugs to specified participants; authorizes the Secretary of Health and Mental Hygiene to include enrollees and recipients of other State prescription drug programs in the Canadian Mail Order Plan.
(Filed 1/23/04; passed Senate 3/31/04; passed House with amendments 4/9/04; not agreed between branches; died 4/11/04)| Imp, Mail

MA
H 4344
Health Care Comm.
Would create a legislative study of most prescription drug bills filed in 2003.
(Favorable report 12/11/03; did not pass by end of formal session 7/31/04)| Study

MA
H 4626
Would create the Massachusetts Internet Prescription Consumer Protection Act.
(Redraft of H 3770; sent to committee 4/1/04; did not pass by end of formal session 7/31/04)| Mail

MA
H 4659
Rep. Rogers
Provides for a declaration of intent of the House of Representatives relative to the amount of senior prescription drug insurance to be approved by the state during FY 2005.
(Filed and adopted by House 148y-2n, 4/13/04) | S

MA
H 4712, H 4714
Lt. Governor
Provides for a voluntary automatic enrollment of current Prescription Advantage beneficiaries into a state-approved and Medicare-approved pharmaceutical discount card, allowing use of the $600 federal transitional assistance benefit.
(Filed 5/10/04; passed House and Senate 5/11/04; signed by governor as Chapter 96 of 2004, 5/12/04) | MMA

MA
H 1A,
H 4600
Governor,
House Ways and Means Comm.
FY05 Budget would impose an enrollment cap for the Prescription Advantage Program. Includes a level-funding appropriation of $96.3 million for the '05 fiscal year. The House amended the budget to increase funding to $110 million.
(Filed 1/29/04; amended by House 4/14/04 and Senate; did not pass in this form; see H 4850 below) S

MA
H 4850 | law
Conference Comm. FY05 Budget provides for: (Line-item 9110-1455) Funding for Prescription Advantage subsidy program at $110 million, a $14 million increase. (Line-item 9110-1460) Funding to reduce copayment amounts in the Prescription Advantage subsidy program, at $5 million. (Sec. 15:) Creates a state ?coordinated, aggregate prescription drug procurement plan" (bulk purchasing), for all state funded or subsidized pharmaceutical purchases. The plan is to include Medicaid, through a separate managed program. The state shall contract with a PBM, with bidding process to include option of a not-for-profit pharmacy benefit manager. Program is to be operational by November 5, 2004.
(Passed House and Senate, 6/20/04; signed by governor as Chapter 149, 6/25/04)|

(Sec. 305) Requires a study and analysis of Medicaid prior authorization, to be completed by 2/1/05. (Vetoed) (Sec. 317) Establishes an Office of Pharmaceutical Information? to ?act as a central agency through which residents may obtain information on procuring prescription drugs at reduced prices?? (Vetoed)
(Sec. 305 & 317 passed House and Senate; Vetoed by governor 6/26/04; override pending 7/04) Bulk, M, MMA, S.

-----

CL, M

MA
S 2207
Health Care Comm.
Would affect payments for manufacturer's coupons by pharmacies, hospitals or other institutions licensed to dispense drugs in the Commonwealth. Requires the Medicaid agency to negotiate supplemental rebates for prescription drugs.
(New committee draft, favorable report 2/9/04; did not pass by end of formal session 7/31/04)| D, M

MA
S 2224
Sen. Tolman
Would affect prior authorization of prescription medications, by requiring telephone, fax or other electronically transmitted approval or denial within 24 hours after receipt of the prior authorization request. Requires automatic coverage of "priority review" products, and establishes notification, and public hearing.
(Filed 1/20/04; favorable report 3/11/04; did not pass by end of formal session 7/31/04)| M, S

MA
S. 2400
Senate Ways & Means Comm.
S. 2400 amendments
FY05 Budget would 1) increase appropriations for the Prescription Advantage program to $110 million, plus $9 million to reduce low-income copayments. Also requires departments to analyze the federal Medicare Prescription Drug Act of 2003, and submit recommendations to legislative Committees by September 1, 2004 on needed changes in state Rx benefits. Also includes a clearinghouse fuction to explain "the additional benefits that would be available to an eligible person under Prescription Advantage but not available under Mediare Part D. (line-item 9110-1455). A separate section would require broader open enrollment and bar copayment increases (Sec. 273) Would state that the program "shall encourage, but not require Prescription Advantage members to utilize the $600 low-income transitional assistance benefit toward prescription drug purchases, but not reduce a person's prescription drug benefit under Prescription Advantage and no individual shall be required to use the Medicare Discount Drug Card, or the $600 in transitional benefit, if the individual's prescription drug benefits would otherwise be less under the Medicare Discount Drug Card.
Floor amendments would 1) provide for a state web site and an Office of Pharmaceutical Information to assist residents with purchasing prescription drugs from Canada. 2) Would establish a voluntary program to allow state employees and retirees, as well as Mass Health and Prescription Advantage enrollees to purchase Rx from licensed Canadian pharmacies approved by the state. 3) Would establish a Rx Fair Pricing program, including bulk purchasing, a PDL with "strict consumer protection and timliness standards" and negotiated manufacturer discounts and supplemental rebates.
(Amendments filed 5/14/04; passed by Senate 5/27/04; amended; see H 4850 above) Bulk, D, Imp, MMA, PDL

MI
HB 4670
Rep. Ehardt
Would expand eligibility in the elder prescription insurance coverage (EPIC) act by including persons in an adult foster care home or assisted living facility, and by not counting federally deductible farm or business income.
(Filed 5/13/03; substituted and passed House 12/9/03; did not pass Senate by end of session 12/04) | S

MI
HB 5435
Rep. Hummel,
HB 5438
Rep. Zelenko
Would provide for the regulation of pharmacy benefit managers, including obtaining a certificate of authority and filing of annual reports. H 5438 would require annual disclosure to the state commissioner and to all purchasers of its coverage about the financial relationships with pharmaceutical industry, billing arrangements with others and prices used in its pricing calculations. [Analysis]
(Filed and sent to committees 1/27/04; 3/23/04; did not pass by end of session 12/04) | PBM

MI
HB 5436
Rep. Richardville
Would regulate mail order and Internet pharmacies, requiring that they be licensed by Michigan. An out-of-state mail-order pharmacy would have to be licensed, certified, or registered to operate in the state in which it was domiciled.
(Filed and sent to committees 1/27/04; 3/23/04; did not pass by end of session 12/04) | Mail

MI
HB 5437
Rep. Plakas
Would require equal co-insurance, copayment and deductibles for community pharmacies and mail order pharmacies.
(Filed and sent to committees 1/27/04; 3/23/04; did not pass by end of session 12/04) | Copay

MI
HB 5549
Rep. Gaffney
Would require handwritten prescriptions to be printed in type, written legibly in ink or indelible pencil and signed by the prescriber.
(Filed 2/17/04; favorable report 5/25/04; did not pass by end of session 12/04) | Lab

MI
HB 5732,
Rep. Whitmer
SB 1095
Sen. Bernero
Would eliminate any prohibition against mail-order pharmacies.
(Filed and sent to committees 3/16/04) Mail

MN
HF 1681

Supplemental budget for health would change eligibility for the MN Precription Drug Program, by adding a requirement that dual-eligible residents as of July 1, 2004 also must apply for a Medicare-endorsed discount card if eligible; drugs covered by the low-income transitional assistance portion will not be covered by the state program. Enrollees in the Medicare drug discount card plan must obtain prescription drugs at a pharmacy enrolled as a provider for both the Medicare drug discount plan and the state prescription drug program.
    Also would authorize the state hemophilia program to contract with a 340B provider for prescription drug discounts and disease management care coordination.
(Filed; passed House 4/2/04; did not pass by end of regular session 6/04)| 340B, MMA, S

MN
HF 1882
Rep. Rukavina,
SF 1857
Sen. Berglin
Would eliminate the current Prescription drug program applicant referral requirement.
(Filed 2/9/04; did not pass by end of regular session 6/04)| M, S

MN
HF 1976
Rep. Wilkin,
SF 1602
Sen. LeClair
Would provide for partial conformity with Health Savings Accounts (HSAs). Allows individuals with high-deductible health plan coverage a state income tax deduction of $2,250 for individuals and $4,500 for individuals with family coverage.
(Filed 2/9/04; did not pass by end of regular session 6/04)| MMA

MN
HF 1998
Rep. Rukavina
SF 1966
Sen. Solon
Prescription drug bulk purchasing. Would direct the state to "establish and administer an intrastate prescription drug bulk purchasing program in order to try to save money for the state, its agencies, and local governments in regard to the cost of the prescription drugs they purchase." Also would provide for the state to negotiate with state-approved Canadian pharmacies or wholesalers the prices to be charged to Minnesota residents who purchase their prescription drugs from Canada pursuant to the state's prescription drug importation program, with coordination by the Minn. Multi-State program (MMCAP).
(Filed 2/12/04; did not pass by end of regular session 6/04)| Bulk, Imp

MN
HF 2086
Rep. Paymar
SF 1971
Sen. Lourey
Would provide for prescription drug marketing expense reporting by pharmaceutical manufacturers' representatives; provides penalties and remedies.
(Filed and sent to committees 2/12/04, 3/17/04; did not pass by end of regular session 6/04)| Mkt

MN
HF 2184
Rep. Paymar,
SF 2189
Sen. Pappas
Would modify the gift ban for prescription drug practitioners, to cover gifts valued at $20 or more per year, replacing the old $50 standard. Violations would be subject to license revocation and $10,000 fine.
(Filed 2/19/04; SF 2189 favorable report 3/17/04; did not pass by end of regular session 6/04)| Mkt

MN
HF 2280
Rep. Huntley
SF 1760
Sen. Berglin
Would require a study of the feasibility of expanded use of the 340B drug pricing for targeted populations. Would authorize contracted use for hemophilia disease management; also requires compilation and description of "all health care providers and facilities in the state potentially eligible" for 340B discount pharmaceuticals.
(Filed 2/5/04; favorable committee reports, 3/15/04; did not pass by end of regular session 6/04)| 340B

MN
HF 2293
Rep. Atkins
Would require the Commissioner of Human Services to implement a program to obtain discounted prescription drugs through Canadian pharmacies; would establish a web site for ordering prescription drugs; would provide state and local employee health plans, state health care programs, health plan companies, and other Minnesota residents access to discounted prescription drugs.
[see Minnesota Governor's "RxConnect" 3/04]
(Filed 2/19/04; did not pass by end of regular session 6/04)| Imp

MN
HF 2598
Rep. Otremba,
SF 2091
Sen. Sams
Would require pharmacists to disclose the cost of prescriptions whenever "part or all of the cost of the prescription is being paid or reimbursed by a group purchaser."
(Filed 3/1/04; favorable report 3/22/04; did not pass by end of regular session 6/04)| Lab

MN
HF 2697
Rep. Strachan
Would authorize the purchase of prescription drugs from foreign nations for county jail inmates as part of any state agency purchase initiative; also would provide for health care insurance coverage or health care services to county jail inmates in 2005.
(Filed 3/3/04; did not pass by end of regular session 6/04)| Imp

MN
HF 2742
Rep. Larson,
SF 2612
Sen. Metzen
Would change eligibility in the state prescription drug discount program (defined in section 256L.09) by excluding a person enrolled in Medicare, or who has employer sponsored Rx coverage.
(Filed 3/3/04; did not pass by end of regular session 6/04)| D, MMA

MN
HF 2758
Rep. Clark,
SF 2672
Sen. Lourey

Would require the state to implement the American Indian pharmaceutical care demonstration project upon federal approval, to "provide culturally specific pharmaceutical care to American Indian medical assistance recipients who are age 55 and older."
(Filed 3/4/04; SF 2672 favorable report 3/25/04; did not pass by end of regular session 6/04)| M, S

MN
HF 2843
Rep. Otto
SF 1650
Sen. Solon
Would establish wholesale and drug manufacturers pharmaceutical pricing reporting requirements, to include "volume discounts, prompt payment discounts, chargebacks, short-dated product discounts, cash discounts, free goods, rebates, and all other price concessions or incentives provided to a purchaser that result in a reduction in the ultimate cost to the purchaser."
(Filed 2/4/04; favorable report 2/26/04; did not pass by end of regular session 6/04)| D, Price

MN
HF 2903
Rep. Finstad
SF 2913
Sen. Lourey
Would establish a geographic access standard for pharmacy services.
(Filed 3/17/04; did not pass by end of regular session 6/04)| -

MN
SF 2601
Sen. Marty
Would require a certificate of authority for pharmacy benefits managers; requires the disclosure of financial information and arrangements related to prescription drug purchasing.
(Filed 3/8/04; did not pass by end of regular session 6/04)| PBM

MS
HB 61
Would create the pharmacy benefit management regulation act; requiring that PBMs receive a license from the Insurance Commission and a certificate of authority; requires the filing of annual statements, financial examinations; and assessments and fees.
(Filed and sent to committee 1/15/04) PBM

MS
HB 66
Would provide that managed care plans cannot restrict providers from prescribing brand name drugs for patients.
(Filed and sent to committee 1/15/04) -

MS
HB 435,
HB 919
Would establish the Prescription Drug Fair Pricing Act, providing discount pharmaceuticals.
(Filed and sent to committee 1/19/04) D

MS
HB 850
Would establish the Senior Rx Program to help seniors access drug manufacturers' discount cards and assistance programs.
(Filed and sent to committee 2/6/04) CL

MS
HB1434
Establishes a Medicaid mandatory preferred drug list (PDL) coupled with a prior authorization program for non-preferred products. Authorizes a partnership with another state to use bulk purchasing power to negotiate lower acquisition costs. Authorizes agreements and negotiations with other countries to facilitate the acquisition of prescription drugs, if allowed by federal law and if it will lower the acquisition costs of those drugs. Modeled after the Florida program, this law increases the prescription limits to four brand names plus unlimited generics. Also requires the use of counterfeit-proof prescription pads.
(Passed House and Senate; signed by governor 5/26/04)
| Governor's summary | A Medicaid waiver was approved 9/9/04 to allow individuals with higher payments to retain Medicaid eligibility. Bulk, Imp, M, PDL

MS
SB 2546
Would create the Pharmaceutical Marketing Disclosure Law; providing for marketing expense reporting by pharmaceutical manufacturers. representatives
(Filed and sent to committee 2/12/04) Mkt

MO
HB 894
Rep. Salva
Would require the Senior Rx Program to provide continued enrollment unless the enrollee opts out of the program, eliminating annual reenrollment.
(Filed 12/17/03; did not pass by end of regular session 5/14/04)| S

MO
HB 1141
Rep. Zweifel
Would modify the Senior Rx Program by requiring an annual income eligibility adjustment based on the rate of change in the Consumer Price Index.
(Filed 2/12/04; did not pass by end of regular session 5/14/04)| S

MO
HB 1641
Rep. Page
Would create "gap" prescription drug coverage for seniors to fill the gap of up to $2850 created due to the enactment of the Medicare Prescription Drug Act of 2003.
(Filed 3/9/04; did not pass by end of regular session 5/14/04)| MMA, S

MO
HB 898,
SB 1160
Sen. Shields
Would establish a prescription drug reuse "repository program", based on donated, sealed and unopened prescription drugs. Effective August 28, 2004.
(Filed 1/26/04;SB 1160 passed Senate 3/10/04; passed House 4/28/04; signed by governor 7/2/04)| Re

MO
SB 1371
Sen. Kinder
Would create state coordination of benefits for the Medicare Prescription Drug Act of 2003. The new Missouri Senior Prescription Drug Plan would pay 75 percent of the standard drug benefit coverage gap of $2,850 for eligible individuals with incomes up to 200 percent of the federal poverty level. Also would terminate elements of the MO Senior Rex program once the Medicare Rx Act is fully implemented.
(Filed 3/1/04; passed Senate 4/1/04; did not pass House by end of regular session 5/14/04)| MMA

MO
SCR 28
Sen. Kennedy
Non-binding resolution would urge the President of the United States to lift the ban on Canadian pharmaceuticals.
(Filed 1/20/04; did not pass by end of regular session 5/14/04)| Imp

MT Montana has no regular 2004 session

NE
LB 1212
Sen. Brashear
Would prohibit insurers from requiring the use of mail order, or from imposing higher co-payments for purchases made at a local pharmacy, except for maintenance drugs prescribed for longer than 90 days.
(Filed 1/21/04; indefinitely postponed, died 2/11/04) | Copay

NE
LB 1226
Sen. Redfield
Would change provisions related to return of dispensed drugs, by allowing returns only from a long-term-care facility to the original dispensing pharmacy for credit, with all tamper-evident seals intact.
(Filed 1/23/04; indefinitely postponed; died, 2/11/04)) Re

NE
LR 331
Sen. Schimek
Would establish a study of issues surrounding the high costs of prescription drugs and availability of such drugs, including "The availability and affordability of safe prescription drugs from Canada."
(Filed 3/30/04; did not pass by end of session)
Bulk, Imp, Study

NV Nevada has no regular 2004 session.

NH
HB 1424
Rep. Burling
Would establish a pharmaceutical study commission to study direct purchasing of prescription medication by the state, buying wholesale prescription drugs and reselling to retail pharmacies and state agencies.
(Filed 2/5/04; passed House 3/31/04; did not pass Senate 4/22/04)| Bulk, D

NH
SB 434
Sen. Martel
Would authorize the state Commissioner of the Department of Administrative Services to establish a program to import prescription drugs from Canada.
[Also see Governor?s Canadian Prescription Drug Report, 3/31/04]
(Filed 1/7/04; passed Senate 3/11/04; amended & passed House 5/5/04; did not pass Conference Comm. 5/25/04)| Imp

NH
SB 383
Sen. Clegg
Would modify pharmacy benefit management; to require a mental health advisory committee to review mental health drugs, and authorize the state to negotiate with pharmaceutical companies for supplemental rebates or price discounts for Medicaid.
(Filed 1/7/04; passed Senate 3/4/04; passed House 5/24/04; signed by governor as Chapter 188, 6/1/04)| M, PBM, PDL

NH
SB 384
Sen. Clegg
Would require that drugs paid for by the state, including the Medicaid program, must be the drug which is least expensive after taking into account all appropriate rebates and other discounts, unless the prescribing practitioner specifies that the brand name drug product is medically necessary.
(Filed 1/7/04; passed Senate 3/11/04; did not pass House 4/15/04)| M, PDL, generic, Price

NJ
A 272
Assm. Kean
Would increase eligibility for the current New Jersey Senior Gold program.
(Filed and sent to committee 1/13/04; held in committee; carried over to 2005 session*) S

NJ
A 488
Assm. Watson,
S 364
Sen. Turner
Would establish the New Jersey Prescription Drug Cost Reduction Study Commission.
(Filed and sent to committee 1/13/04, 11/04; carried over to 2005 session*) D, Study

NJ
A 547
Assm. Myers,
A 702
Assm. Bodine,
A 741
Assm. Cohen
Would repeal law that provides that the distribution of premiums or rebates by pharmacists to persons under 62 years of age constitutes grossly unprofessional conduct. A 547 & A 741 would allow pharmacists to offer premiums or rebates to customers of any age. A 702 would reduce the age to under 60.
(Filed and sent to committee 1/13/04; held in committee; carried over to 2005 session*) D, price

NJ
A 1593
Assm. Burzichelli,
A 2315
Assm. VanDrew,
S 590
Sen. Sweeney
Would enact the "New Jersey Fair Market Drug Pricing Act" and establish the New Jersey Rx Card Program to reduce prescription drug prices. Would use voluntary negotiations with drug companies for supplemental rebates. Residents eligible would include Medicare enrollees and others with income up to 300 percent of federal poverty, who do not have other state or private pharmaceutical coverage.
(Filed and sent to committee 2/9/04; A 1593 amended, reported from committee 6/14/04; carried over to 2005 session*) D, M, MMA

NJ
A 2082
Assm. Munoz
Would change the copayments for Pharmaceutical Assistance for the Aged and Disabled (PAAD) to $5 for first two prescription drugs per month and $2 for additional prescriptions.
(Filed and sent to committee 2/9/04; held in committee; carried over to 2005 session*) S

NJ
A 2376,
A 2377
Assm. Gibson, Azzolina
Would establish the "Medicare Rx Savings Fund" and specify use of savings to the state from the Medicare prescription drug benefit.
(Filed and sent to committee 2/24/04; held in committee; carried over to 2005 session*) MMA

NJ
A 2439
Assm. Weinberg
Would prohibit writing of online prescriptions for persons who have not been examined by a licensed prescriber.
(Filed and sent to committee 2/24/04; held in committee; carried over to 2005 session*) Mail, Internet

NJ
A 2549
Assm. Chiappone
Would require drug manufacturers to offer their drugs to purchasers on terms and conditions offered to most favored purchaser.
(Filed and sent to committee 3/15/04; held in committee; carried over to 2005 session*) D, Price

NJ
A 2607
Assm. Payne
Would require the Medicaid program to pay recipients' Medicare prescription drug copayments.
(Filed and sent to committee 3/15/04; reported favorably from committee 6/3/04; carried over to 2005 session*) MMA

NJ
A 2628
Assm. Gusciora
Would increase the income eligibility limitsby $5,000 for Pharmaceutical Assistance for the Aged and Disabled program and Senior Gold Prescription Discount Program.
(Filed and sent to committee 5/3/04; held in committee; carried over to 2005 session*) S

NJ
A 3039
Assm. Manzo
Assesses insurers and health maintenance organizations $8.1 million to defray cost of Prescription drug benefits for certain Medicaid recipients.
(Filed and sent to committee 6/14/04; carried over to 2005 session*) M

NJ
A3437,
S2014
Assm. Bodine

Would prohibit the sale of Flu Vaccine at excessive prices during shortage.
(Filed and sent to committee 10/25/04; carried over to 2005 session*)
See SIGNED LAW S 1997, below
Price

NJ
A 3289,
S 1231
Assm Scalera,
Sen. Sarlo
Would regulate Internet pharmacies and electronic prescriptions.
(Filed and sent to committee 2/24/04; A 3289 passed Assembly by 77y-0n, 12/13/04; carried over to Senate 2005 session*) Mail, Internet

NJ
A 3595,
S 1455
Sen. Bark
Would extend eligibility for the Pharmaceutical Assistance program (PAAD) to additional disabled persons.
(Filed and sent to committee 4/25/04; held in committee; carried over to 2005 session*) S

NJ
S1997
Sen. Vitale
A3450

Authorizes NJ DHSS to reallocate Flu Vaccine to high-risk persons.
(Filed, S 1997 passed Senate and Assembly 10/25/04; signed by governor as PL-2004 Chapter 153, 10/27/04) |

Flu, -

NJ
ACR 122
Assm. Thompson,
SCR 48
Sen. Singer
Would propose a constitutional amendment requiring federal funds received by State under Medicare prescription drug program be used to expand Pharmaceutical Assistance for the Aged and Disabled and Senior Gold Prescription Discount Program.
(Filed and sent to committee 1/22/04 & 2/5/04; carried over to 2005 session*) MMA, S

NM
HB 88
Rep. Picraux,
SB 264
Sen. Feldman
Directs the Human Services Department to mandate a 340B drug pricing program. All "programs, clinics, hospitals and other health-related centers and entities, including those identified by the Human Services Department (for Medicaid), that are eligible under Section 340B..., including hospitals and clinics licensed under the state Public Health Act, shall participate in that Section 340B federal prescription drug price discount program.
(Filed 1/23/04; passed House and Senate; HB 88 signed by governor 3/3/04 as Chapter 47 of 2004) | 340B, M

NM
HB 169
Rep. Vigil
Would require standard copayments on prescription drug purchases in health insurance.
(Filed and sent to committee, 1/22/04; died at end of session, 2/19/04) | Copay

NM
HB 466
Rep. Park
Would create the cancer drug repository program; allows unused and unadulterated cancer drugs to be donated for the use by an eligible individual or entity; enacts the Cancer Drug Repository Act.
(Filed and sent to committee 2/2/04; died at end of session, 2/19/04) | Re

NM
HB 497
Rep. Picraux
Would expand eligibility of the senior prescription drug program administered by the Retiree Health Care Authority.
(Filed and sent to committee 2/2/04; died at end of session, 2/19/04) | D

NM
HB 551,
S.B. 378
Would enact the Drug Pricing Disclosure Act; requiring pharmacists to provide prices to consumers upon request.
(Filed and sent to committee 2/4/04; died at end of session, 2/19/04) | D, Price

NM
SB 278
Sen. Coll
Would appropriate state funds to support availability of pharmacy services in primary care clinics in rural and medically underserved areas.
(Filed 1/27/04; favorable committee report, 2/2/04; died at end of session, 2/19/04) | 340B

NY
A 9298
Assm. Hooper
Would authorize licensed distributors to purchase and distribute certain drugs and pharmaceuticals purchased from international drug companies.
(Filed 12/30/03, sent to committee 1/7/04; did not pass by end of session 12/04; refiled for 2005-06 as A 4506) || Imp

NY
A 9352
Assm. Cahill
Would provide for the proper packaging and labeling of pharmaceutical drugs; creates penalties for intentional fraudulent replacement, packaging, and labeling of such drugs. Would make false labels and misrepresentations of pharmaceutical drugs as a fraud subject to civil penalties.
(Filed and sent to committee, 1/7/04; did not pass by end of session 12/04; refiled for 2005-06 as A 2040) ||
Lab

NY
A 9535,
S 5683
Assm. Lavelle
Would provide that a beneficiary of an insurance policy which provides coverage for prescription drugs shall not be disqualified from receiving such insurance benefits where such beneficiary also receives benefits under a federal Medicare prescription insurance plan.
(Filed and sent to committee, 2/20/04; did not pass by end of session 12/04; refiled for 2005-06 as A 7569 & S 4705)
MMA

NY
A 9591,
S 5975
Assm. Englebright,
Sen. Golden
Would provide for cost of living and marriage penalty adjustments to eligibility standards for the program for Elderly Pharmaceutical Insurance Coverage (EPIC).
(Filed and sent to committee 2/10/04; did not pass by end of session 12/04; refiled for 2005-06 as A 7693 & S 2971) || S

NY
A 9899,
S 6352
Assm. John,
Sen. Hannon
Would establish the program for state cost reduction in pharmaceuticals within the department of health; provides for the bulk purchase by the state of all pharmaceuticals used by the state or paid for by the state; provides for mandatory participation; requires the deposit of drug rebates into a fund for the elderly pharmaceutical insurance coverage program.
(Filed and sent to committee, 3/1/04; did not pass by end of session 12/04; refiled for 2005-06 as S 4235) || Bulk, S

NY
A 10009
Assm. Gottfried

Would require drug retail price lists to be posted in a database on the website of the State Board of Pharmacy; requires every pharmacy to update its drug retail list electronically to the Board each week and requires pharmacies to post the website address of the Board on a sign posted in the pharmacy.
(Filed and sent to committees, 3/2/04; did not pass by end of session 12/04; refiled for 2005-06 as A 5403A & S 1936A) D, Price

NY
A 10233,
S 6635
Assm. John
Sen. Koon
Would direct the Office of General Services to study and report on procurement strategies and practices that may lower the cost of prescription drugs to the state, municipalities, and state residents.
(Filed and sent to committee, 3/16/04; did not pass by end of session 12/04; refiled for 2005-06 as A 1635 and S 0114) || D, Bulk, Study

NY
A 10343,
S 6552
Assm. Brodsky
Would require Rx manufacturers which engage in marketing activities in the state to annually report marketing expenses; with a $100,000 civil fine for failure to report.
(Filed and sent to committee; did not pass by end of session 12/04; refiled for 2005-06 as A 2769 and S 3695) ||
Mkt

NY
A 10440,
A 10450,
S 1229
Assm. Brennan
Would prohibit health insurers from requiring use of mail-order drugs, or from charging a different co-payment fee for retail store versus mail-order purchases.
(Filed and sent to committee 3/30/04; did not pass by end of session 12/04; refiled for 2005-06 as A 2766, A 6934 and S 2894) || Co-pay, Mail

NY
A 11067
Rules Comm.,
S 7226
Finance Comm.
FY04-05 emergency budget bill authorizes optional automatic enrollment in endorsed Medicare Rx discount cards, for NY residents enrolled in the EPIC Rx subsidy program, including waiving of any sign-up fees. The state program is authorized to endorse one or more Medicare Rx discount card sponsors that agree to "effective coordination" of benefits with the state.
(Filed 5/3/04, passed Assembly and Senate and signed by governor as Chapter 49, 5/3/04) MMA

NY
A 11667,
S 6005
Assm. Colton,           Sen. Golden

Would provide for the establishment of a state pharmaceutical purchasing program with a pharmaceutical purchasing panel.
(Filed 1/20/04, amended by committee 6/18/04; did not pass by end of session 12/04; refiled for 2005-06 as S 5028) || Bulk

NY
S 6363
Sen. Seward
Would expand the coverage under the Elderly Pharmaceutical Insurance Coverage (EPIC) program to include any unmarried or married residents, within the eligible income, who are disabled, as defined under the human rights law.
(Filed and sent to committee 3/5/04; in committee 7/04) S

NY
S 6498
Assm. McDonough,      Assm. Mayersohn

Would require prescriptions to be typewritten, electronically printed or handwritten in ink or indelible pencil in a legible manner; requires that handwritten prescriptions shall only be written in print letters; prohibits the use of script letters in handwritten prescriptions.
(Filed and sent to committee 3/16/04; did not pass by end of session 12/04; refiled for 2005-06 as A 4090, A 4437 & S 2231 ) ||           Lab

NY
S 6948
Sen. Maziarz
Would establish regulation of pharmacy benefits managers by requiring: a license from the Department of Insurance and Pharmacy Board, disclosure of agreements for rebates and discounts from pharmaceutical manufacturers, and annual financial staements filed with the state. Also would prohibit discrimination between pharmacies on the basis of copayments or days of supply.
(Filed and sent to committee 4/19/04; in committee 7/04) PBM

NC
H 1414
Appropriations Chairs

FY05 budget (Sec. 10.2B) would authorize voluntary automatic enrollment in a Medicare-endorsed Rx discount card for current and future participants in the state's Senior Care PDA program with income up to 135 percent of federal poverty, including an option for individuals to decline; also clarifies that the state is the payor of last resort.
Also (in Sec. 10.19(h)) requires generic substitution in Medicaid, with specified exceptions for atypical antipsychotic and NTI drugs .
Also (in Sec. 10.19(a)) provide for Medicaid Rx limit of six per month, with a dispensing fee retained at the current $5.60 for generics and $4.00 for brand names.

Also (Sec. 31.29- DELETED IN CONFERENCE) would set a 4-tier copayment for public employee health plan, from $10 to $40.
(Passed House 6/8/04; passed Senate 6/24/04; signed by governor 7/20/04) Copay, MMA, M, S

NC
FY04-05 Budget recommendations
Governor Governor's FY04-05 budget adjustment recommendations would lower state ingredient reimbursement from AWP-10% to AWP-13% and reduce dispensing fees to pharmacies from $4 to $3, for a projected savings of $10 million.
(Transmitted 5/11/04; did not pass as legislation in House or Senate) M

ND North Dakota has no regular 2004 session.

OH
SB 80
Sen. Stivers
Relates to tort reform and product liability claims and claims based on unsafe condition and modifies the provision on frivolous conduct in filing civil actions; prohibits imputing any assurances or assumption of liability regarding wrongful death; includes medical and drug liability and health care workers. Establishes that a prescription drug or medical device "is not defective in design or formulation because some aspect of it is unavoidably unsafe, if the manufacturer of the ethical drug or ethical medical device provides adequate warning and instruction concerning that unavoidably unsafe aspect." If a claimant alleges in a product liability claim that a drug or device caused harm to the claimant, the manufacturer of the drug or device shall not be liable for punitive or exemplary damages in connection with that product liability claim if the drug or device that allegedly caused the harm either meets FDA standards or is an over-the-counter product.
(Filed 5/1/03; passed Senate 6/11/03; passed House 12/18/04; signed by governor 1/6/2005) Liability

OH
SB 198
Sen. Blessing
Would require retail sellers of prescription drugs to disclose price information for the top 100 used drugs to consumers, updated every three months.
(Filed and sent to committee, 2/12/04; in committee 6/1/04) D, Price

OK
HB 1866,
Rep. Gilbert,
HB 1834
HB 2283,
HB 2688
Rep. Erwin
Expands the scope of the Utilization of Unused Prescription Medications Act, to be operational by January 1, 2005, to benefit "residents who are medically indigent."
(HB 1866 Filed 1/8/04, passed House; passed Senate; signed by governor 5/28/04)|
(HB 1834, HB 2283, HB 2688 did not pass)| Re

OK
HB 2111
Rep. Kirby,
SB 1615
Sen. Lawler
Would create the Oklahoma Prescription Drug Fair Pricing Act; creates the Oklahoma Prescription Drug Fair Pricing Board; provides for membership, terms, officers, travel reimbursement and staff support; makes proceedings of Board subject to certain requirements; specifies the powers and duties of the Board. Also would authorize the state to "establish maximum prices for prescription drugs."
(Filed 1/16/04, did not pass by end of regular session 6/04)| D, Price

OR Oregon has no regular 2004 session

PA
HB 2493
Rep. Allen
Would extend coverage of the Pharmaceutical Assistance (PACE) program to include coverage for disabled individuals.
(Filed and sent to committee 3/31/04; did not pass by end of session 12/04) | S

PA
HR 645
Rep. DeLuca
Non-binding resolution, requests the US Congress to "enact legislation to lift current barriers that prevent the importation of drugs from Canada."
(Filed and sent to committee 3/31/04; did not pass by end of session 12/04) | Imp

PA
SR 207
Sen. Orie
Non-binding resolution, would memorialize the U.S. Congress to designate the PACE subsidy program as the enroller of Medicare and Medicaid recipients of the drug benefit under the Medicare Prescription Drug Improvement and Modernization Act of 2003.
(Filed and sent to committee 3/16/04; did not pass by end of session 12/04) | MMA

RI
H. 7199
Rep. Palumbo
Would allow certain Canadian pharmacies to obtain a license to dispense prescriptions.
(Filed and sent to committee, 1/14/04; did not pass by end of session 6/04; see H 7320 below) Imp

RI
H. 7320
Rep. Anguilla,
S. 2160
Sen. Badeau
Would allow pharmacies licensed in Canada to obtain licensure from the state Department of Health to do business in Rhode Island; the primary requirement is payment of an annual license fee. The RI Board of Pharmacy may exercise its authority in the event of misconduct by such pharmacy. The law would take effect 1/15/05 and would be repealed on 12/31/07 unless reenacted..
(H. 7320 filed 1/22/04; passed House 4/27/04; passed Senate 6/24/04; became law without governor's signature as Chapter 364, 7/5/04)
S. 2160 filed 1/27/04; passed Senate 4/29/04; passed House 6/24/04; became law without governor's signature as Chapter 371, 7/3/04)
NOTE: The FDA issued a letter on 7/3/04 asserting this law conflicts with the Federal Food and Drug Act) Imp

RI
H. 7374
Rep. Moura,
H. 7703
Rep. Reilly
Would establish the Rhode Island Fair Market Drug Pricing Program. This program would establish a state pharmaceutical assistance program whereby the state would negotiate supplemental rebates or discounted prices from drug manufacturers. These discount savings would be passed on to consumers.
(H. 7374 passed House 6/25/04; passed Senate 6/25/04; signed by governor as Chapter 341, 7/2/04)
(H. 7703 Filed 1/27/04; did not pass by end of regular session 6/04)| D

RI
H. 7415
Rep. Constantino
Would authorize the Department of Administration to enter into contracts with manufacturers and suppliers of drugs on behalf of various state departments in order to obtain discounts, rebates or refunds as permissible under federal law.
(Filed and sent to committee 1/29/04; did not pass by end of regular session 6/04)| Bulk, D

RI
H. 7416
Rep. Constantino
Would establish the 10-member Special Legislative Committee to Reconcile the Provisions of the Pharmaceutical Assistance Program with the Medicare Prescription Drug Act of 2003, to study the effect of the new federal act on the Rhode Island Pharmaceutical Assistance for the Elderly Program, and make recommendations to ensure the maximum possible coverage and benefit to eligible consumers. (also see H. 7630)
(Filed 1/29/04; passed House 4/22/04; passed Senate 6/23/04; became law without governor's signature as Chapter 240, 7/1/04)| MMA

RI
H. 7515
Rep. Giannini
Would require that Medicare Advantage Plans (Medicare + Choice) offering prescription drug plans must provide enrollees with access to the negotiated prices used for the payment of covered drugs prior to the application of co-payments, co-insurance payments or other cost-sharing mechanisms.
(Filed 2/4/04; amended, passed House but did not pass Senate by end of regular session 6/25/04) MMA

RI
H. 7626
Rep. Constantino
Would authorize the Medicaid office to utilize generic substitution, whenever the generic is less costly than the brand name, provided that the program consider the amount paid by the state to the pharmacy for a drug under the current retail pharmacy reimbursement formula, less discounts or reductions.
(Filed 2/10/04; passed House 5/27/04; passed Senate 6/25/04; became law without governor's signature as Chapter 552, 7/9/04)| M, Generic

RI
H. 7630
Rep. Constantino
For those qualified for the state Pharmaceutical Assistance to the Elderly (subsidy) program, requires the state to pay the eligible percentage of the cost of prescriptions for qualified drugs for which no payment or reimbursement is made by the federal government, including Medicare. The state program continues its sliding scale copayments of 40 percent, 70 percent and 85 percent (up to $35,000 annual income for an individual.)
(Filed 2/10/04; passed House 6/24/04; passed Senate 6/26/04; became law without governor's signature as Chapter 466, 7/7/04)| MMA, S

RI
H. 7807
Rep. Kilmartin
Would require drug manufacturers and their marketers to disclose all the gifts that they give to the prescribers or dispensers of prescription drugs. In addition, it would restrict the monetary value of the gifts to $150 per gift and $450 per year to each recipient.
(Filed and sent to committee 2/12/04; did not pass by end of regular session 6/04)| Mkt

RI
H. 8023
Rep. Wasylyk
Would require pharmacies to post the price for a one month and three month supply of prescription medicines.
(Filed and sent to committee 2/24/04; did not pass by end of regular session 6/04)| Price, -

RI
H. 8272
Rep. Giannini,
S. 3015
Sen. Goodwin
Non-binding resolutions would urge the U.S. Congress to revise certain provisions of the Medicare Prescription Drug, Improvement and Modernization Act of 2003, including eliminating the prohibition on the federal government negotiating lower prices for drugs, narrowing the gap in the "doughnut hole," and liberalizing the restrictive asset test for persons with low incomes.
(H 8272 House resolution filed 3/10/04, passed House as certified Resolution #351, 6/22/04;
S. 3015 Joint resolution passed Senate 4/22/04; passed House as certified Resolution #366, 6/24/04) MMA

RI
S 2886
Sen. Paiva-Weed

Establishes the Rhode Island Prescription Drug Discount Program for the Uninsured program, to serve residents ages 19 to 65 with annual income up to 200% of federal poverty. Enrollees will pay an annual fee of up to $30; program to be implemented by March 15, 2005.
(Filed 2/11/04; passed Senate and House, signed by governor as Chapter 357, 7/2/04)
D

SD
HB 1165
Rep. Glenski
Would allow unused unit dose drugs from patients in a hospice program, a nursing facility, or an assisted living facility to be returned to the pharmacy that dispensed the drugs for credit and redispensing, under controlled circumstances including sealed packaging and other safety requirements.
(Filed 1/22/04; passed House 2/5/04; passed Senate 2/11/04; signed by governor, 2/19/04) | Re

SD
HB 1310
Governor
Would provide for a pharmacy benefits management authority and to provide for its powers and duties.
(Filed and sent to committee 1/28/04; tabled in committee, did not pass 2/11/04) | PBM

SD
HB 1311
Governor
Provides for the regulation of pharmacy benefits management (PBMs), including licensing, "exercising good faith and fair dealing" toward covered entities including health plans, employers, state agencies and others providing Rx coverage. Entities contracting with a PBM may request disclose to the covered entity, the amount of all rebates and other revenues received from pharmaceutical manufacturers, and may obtain an audit of PBM records regarding such transactions. PBMs must treat utilization information as confidential.
(Filed and sent to committee 1/28/04; passed House 2/12/04; passed Senate 2/24/04; signed by governor 3/9/04) | PBM

SD
HB 1312
Governor
Would authorize the discontinuance of the senior prescription drug program (discount program enacted in 2003) within 120 days following the issuance of the Medicare prescription drug discount card.
(Filed 1/28/04; passed House 2/12/04, passed Senate 2/24/04; signed by governor 3/9/04) | MMA

TN
HB 2173
Rep. Turner,
SB 2545
Sen. Harper
Would require the governor and State Insurance Committee to request federal approval for importation of prescription drugs from Canada, with protections to insure only quality prescription drugs are imported.
(Filed and sent to committees 1/04; did not pass by end of regular session 5/21/04)| Imp

TN
HB 2694
Rep. Armstrong,
SB 2162
Sen. Dixon
Creates the "Medication Error Reduction Act" for a uniform standard format, requiring written prescription orders to be legible and comprehensible to a pharmacist; would limit the liability of pharmacists for delay incurred when clarifying a prescription that the pharmacist cannot understand.
(Filed 1/04; SB 2162 passed Senate 3/24/04; passed House 4/29/04; signed by governor as Chapter 678, 5/18/04)| Lab

TN
HB3162
Rep. Shaw ,
SB 2714
Sen. Kyle
Would direct the comptroller of the treasury to report annually to the select oversight committee on TennCare concerning the implementation of the elements of the prescription drug program waiver.
(Filed and sent to committee 1/22/04; did not pass by end of regular session 5/21/04)| S, M

TN
HB 3374
Rep. Shepard,
SB 3014
Sen. Herron
Would require the Department of Health to initiate an outreach program to provide low-income and TennCare eligible residents information, education and assistance relative to obtaining prescription drugs at discounted cost, similar to program established in commission on aging to provide such assistance to Medicare-eligible Tennesseans.
(Filed and sent to committee 2/5/04; did not pass by end of regular session 5/21/04)| CL, MMA

TN
SR 158
Sen. McNally
Non-binding Senate resolution, would urge the US Secretary of HHS to "take necessary steps to stop sale and importation of prescription drugs" over the Internet.
(Filed 4/1/04; favorable committee report 4/28/04; did not pass by end of regular session 5/21/04)| Imp, Mail

TX Texas has no regular 2004 session. See 2003

UT
HB 69
Rep. McGee
Would require a pharmacist to dispense a generic drug in substitution of another drug if the generic is less expensive and is biologically equivalent.
(Filed and sent to committee 2/13/04; died in House 3/3/04) | Generic

UT
HB 267
Rep. Hogue

Would create the Utah Pharmaceutical Insurance Program within the Department of Health, to serve residents age 19 and over with household incomes of no more than 200 percent of federal poverty level. Enrollment would require a $100 annual premium, and copayments ranging from $15 to 30 percent of the cost
of the prescription, with a limit of four per month. Would include an option for premium assistance for a Medicare prescription drug plan.
(Filed and sent to committee 2/12/04; died in House 3/3/04) | MMA, S

VT
H. 493
Rep. Koch
Would amend provisions of the Healthy Vermonters pharmacy discount plan; including regulating pharmacy benefit managers; requiring the disclosure of retail prescription drug prices. It would exempt certain mental health drugs from the prior authorization process and assist Medicare beneficiaries with paying drug costs not covered under the federal Medicare drug benefit.
(Filed 12/26/03 and sent to committee 1/6/04; did not pass by end of regular session 5/20/04) | D, Mkt, MMA

VT
H. 502 Rep. Obuchowski
Would require the state, municipalities, and school boards to purchase drugs covered by a health benefit plan, from Canadian sources.
(Filed and sent to committee 1/6/04; did not pass by end of regular session 5/20/04) | Imp

VT
H. 532
Rep. Martin
Would require public disclosure of prescription drug marketing costs by pharmaceutical manufacturers.
(Filed and sent to committee 1/8/04; did not pass by end of regular session 5/20/04) | Mkt

VT
H. 617
Rep. Heath
Would regulate pharmacy benefit managers "to protect against unfair prescription drug practices."
(Filed and sent to committee 1/23/04; did not pass by end of regular session 5/20/04) | PBM

VT
H. 638
Rep. Fisher
Would prohibit advertising prescription drugs on broadcast media.
(Filed and sent to committee 1/27/04; did not pass by end of regular session 5/20/04) | Mkt

VT
H. 713
Rep. Mazur
Would establish the small business health care tax incentive program; creates the health care cost containment council. It would require pharmaceutical marketers to make prescription drug price disclosures and require pharmacy benefit managers to provide supplemental financial quotations which identify sources of revenue.
(Filed and sent to committee 2/3/04; did not pass by end of regular session 5/20/04) | Mkt, PBM

VT
H. 728
Rep. Tracy
Would direct the state to establish a program to provide for and facilitate the purchase of prescription drugs from Canada.
(Filed and sent to committee 2/6/04; did not pass by end of regular session 5/20/04 - see H. 768 below) | Imp

VT
H. 768
Appropriations Comm.
FY 2005 Appropriations Act provides:
     (Sec. 128a) Retail pharmacists are required to disclose prescription drug prices to consumers on reques; (Sec 128b) pharmaceutical marketers are required to disclose prescription drug "AWP" prices to health care professionals, and report gifts and marketing expenditures to the Attorney General;
    (Sec. 128d) state pharmaceutical assistance programs are required to provide coverage for over-the-counter drugs listed on the state preferred drug list; pharmacy benefit managers and health insurers are required to permit retail pharmacists to use same prices and quantity as mail-order pharmacies; the state department (PATH) is required to implement an evidence-based research program featuring generics and "counter-detailing", by January 1, 2005;
     (Sec. 128g) PATH is required to study the expansion of federal 340B programs, including use in managed care, state bulk purchasing and inmate populations; PATH is required to extend the mental illness drug exemption for another two years; PATH is required to report on the financial impact of the new federal Medicare drug benefit; the department of aging and disabilities is required to convene a drug benefit working group to minimize confusion regarding drug discount cards; PATH is required to create a pilot prior authorization exemption program by December 31, 2004.
    Also requires (in Sec. 128l) that the state "shall establish a program to describe how Vermont residents are able to purchase prescription drugs from Canada, including "information about ordering through the mail or otherwise from a participating Canadian pharmacy. The department shall establish a website and written information regarding the program." Also, health insurance plans are required to provide coverage for drugs purchased in Canada and reimported legally.
     The Healthy Vermonters Plus program is created (in Sec. 128o), extending prescription drug discounts to persons under 65 with income between 300 and 350 percent of federal poverty, or with Rx expenses at least 15 percent of total income, but not eligible for the existing Healthy Vermonters program. The discount in the program "shall reflect any rebates negotiated between the state and drug manufacturing companies."
(Passed House and Senate 5/20/04, signed by governor as Act 122, 6/10/04) | 340B, Bulk, D, Generic, Imp, Mail, Mkt, MMA, PDL, Price, S, Study

VT
S. 276
Sen. Bloomer
Would direct the Department of Prevention, Assistance, Transition, and Health Access (PATH) to establish a program to publicize and facilitate the purchase of prescription drugs from Canada by providing information to consumers.
(Filed 12/23/03; sent to committee 1/6/04; did not pass by end of regular session 5/20/04) | Imp

VT
S. 288
Sen. Leddy
Would require "pharmacy benefit managers or health insurers to disclose prescription drug prices to consumers and health care providers"; includes over the counter drugs on the state's preferred drug list (PDL); amends the Healthy Vermonters prescription drug program; requires the licensing of PMB's; provides the office of the attorney general with investigative power under the disclosure laws applicable to pharmaceutical marketers; requires the use of the state's preferred drug list in the state employees' health benefit plan. Also requires a study of "the feasibility of providing discounted prescription drugs to vulnerable patient populations through the use of Section 340B" federal drug discounts. Also would require the state to convene a working group to "develop and implement a plan to include outreach, education, and assistance to minimize confusion and duplication of coverage expected to be caused by the introduction of the new, federally mandated Medicare discount cards", for those who also are eligible for Medicaid, VHAP-Rx, VScript, VScript Expanded, or Healthy Vermonters. Also specifies that the state shall establish a program to describe how residents are able to purchase prescription drugs from Canada, including mail-order options and a state-sponsored website. Would specify that any health insurer "shall cover prescription drugs purchased outside this country on the same terms... as drugs purchased in this country."
(Filed and sent to committee 1/13/04; passed Senate 3/17/04; did not pass by end of regular session 5/20/04) | 340B, D, Imp, Mkt, MMA, PBM, PDL

VT
JRS 40
Sen. Leddy
Non-binding resolution urges Governor James Douglas to establish a drug reimportation program for the state.
(Filed 1/6/04; passed Senate 1/14/04; passed House, 1/21/04 as Resolution R235) | Imp

VA
HB 190
Del. Black
   Would provide that the state "shall evaluate and may implement, if feasible and cost effective and consistent with federal law and regulation," a process for purchasing reduced-cost prescription drugs from Canada for the state employees Health Benefits Program. The study would include the state pharmacy board, the state attorney general, and "may consult" with the FDA and federal officials.
(Filed 1/7/04; did not pass committee 1/22/04) | Imp

VA
HB 197
Del. Purky
   Would establish the Virginia Insurance Plan for Seniors (VIPS), providing up to $80 per month to eligible enrollees, defined as dual-eligible Medicare people age 65 and over. Prescription drugs would be limited to all products whose manufacturers agreed to provide a discount via rebate equal to the Medicaid rebate. The plan would require the use of generic drugs when available, or require enrollees to pay the balance above the generic price. Enrollees would pay a 10 percent copayment.
(Filed and sent to committee 1/14/04; tabled, did not pass House 1/22/04) | MMA, S

VA
HB 266
Del. Morgan
   Would require issuing and use of uniform prescription cards for all commercial health plans; includes requirement that insurers "shall pay the prescription benefit provider by electronic funds transfer or automated clearing house transfer within 30 days of receipt of such claim."
(Filed and sent to committee 1/14/04; did not pass; carried over to 2005, 1/27/04) -

VA
HB 359
Del.
BaCote
   Would require the state to establish a mechanism by 2005 so that all clinics that maintain pharmacy services "shall continue to provide free or low-cost prescription drugs (on a sliding fee scale) to any low-income patients who do not have any prescription drug benefit and whose primary and specialty health care services have been transferred to a community health clinic", also requires use of manufacturer free drug programs where available.
(Filed and sent to committee 1/14/04; tabled, did not pass House 1/27/04) | D, 340B

VA
HB 1202
Del. Cline
Requires the Commissioner of Health and the Commissioner of the Department for the Aging to develop a single application form for Virginians to use to seek eligibility for various pharmaceutical assistance programs and pharmaceutical discount purchasing cards. Also requires state agencies to "coordinate the dissemination of information to the public regarding any pharmaceutical discount purchasing card programs while maintaining a neutral posture regarding such programs," as well as other Medicare law-related benefit information.
(Filed 1/14/04; passed House 1/30/04; passed Senate 3/15/0;  signed by governor as Chapter 318, 3/31/04) | CL, MMA

VA
HJR 85
Del. Marshall
Would establish a joint subcommittee to study "the escalating cost of health care in Virginia; including "dramatically rising prescription drug costs, related to factors such as increased patient demand and education as a result of direct consumer advertising, and the introduction of new and expensive drug therapies."
(Filed and sent to committee 1/14/04; tabled, did not pass House, 2/14/04) | study

VA
HJ 199
Del. Armstrong
Non-binding resolution would request the U.S. Congress to remove current restrictions on the purchasing of prescription drugs from Canada.
(Filed and sent to committee 1/14/04; did not pass; carried over to 2005, 2/11/04) | Imp

VA
SB 158
Sen. Potts
Requires the Commissioners of Health and the Department for the Aging to disseminate, with such funds as may be made available, information to the public relating to recent congressional actions relating to pharmaceutical benefits to be provided under the Medicare program and how such benefits may help senior citizens with the costs of pharmaceutical benefits. including training of senior volunteers.
(Filed and sent to committee 1/14/04; passed Senate and House; signed by governor as Chapter 73, 3/12/04) | CL MMA

VA
SB 377
Sen. Deeds
Would establish the Virginia Prescription Drug Payment Assistance Program; funded from proceeds of the Master Tobacco Settlement Agreement. Eligibility requirements include people age 65 or older, or disabled between ages 19 and 64, with annual income not more than 150 percent of federal poverty guidelines. Enrollees would pay a 25 percent copayment, with maximum annual benefit capped at $2500. Beneficiaries must not have any other third party payor prescription benefit as of July 1, 2004.
(Filed and sent to committee 1/14/04, did not pass, carried over to 2005, 2/4/04) | S

WA
HB 2469
Rep. Simpson
Would authorize certain state agencies to purchase prescription drugs from Canadian wholesalers and pharmacies. Requires the state to create a web site regarding opportunities to purchase prescription drugs from Canada and the best means to ensure that any prescription drugs they purchase have been safely manufactured. The final House version adds, "Agencies administering a state-purchased health care program shall not implement the provisions of this act relating to the bulk purchasing of prescription drugs from Canada until federal statutory or regulatory action is taken to authorize such purchasing."
(Filed 1/13/04; passed House 90y-7n, 2/13/04; did not pass Senate by end of regular session 3/11/04) | Imp

WA
SB 6504
Sen. Brown
Would provide for prescription drug discounts negotiated by the health care authority, to benefit any resident with annual income not more than 300 percent of federal poverty, and age 50 or older or disabled.
(Filed and sent to committee 1/21/04; ; did not pass by end of regular session 3/11/04) | D

WV
HB 2061
Del. Armstead,
HB 2153,
SB 3
Would create the senior citizens prescription drug subsidy program, with funding through a voluntary state income tax check-off.
(Filed and sent to committee 1/14/04; did not pass by end of regular session 3/20/04) | S

WV
HB 2128
Del. Fleischauer
Would increase the access to medicines for needy seniors through programs to be administered by the Secretary of Health and Human Resources.
(Filed and sent to committee 1/14/04; did not pass by end of regular session 3/20/04) | CL, D

WV
HB 2263
Del. Fleischauer
Would create the West Virginia Prescription Drug Fair Pricing Act, to provide for discount pharmaceuticals to elders and low income residents, using element from the Maine Rx program.
(Filed and sent to committee 1/14/04; did not pass by end of regular session 3/20/04) | D

WV
HB 2366
Del. Border
Would require health benefit plans to issue uniform prescription drug information cards or technology.
(Filed and sent to committee 1/14/04; did not pass by end of regular session 3/20/04) | -

WV
HB 2773
Del. Martin
Would create the Prescription Drug Price Reduction Act.
(Filed and sent to committee 1/14/04; did not pass by end of regular session 3/20/04) | D

WV
HB 4062
Del. Foster
Would regulate and require licensing of pharmaceutical marketers and "detailers".
(Filed and sent to committee 1/17/04; did not pass by end of regular session 3/20/04) | Mkt

WV
HB 4084
Del. Michael
West Virginia Pharmaceutical Availability and Affordability Act: 1) establishes a state-sponsored clearinghouse for consumer Rx information; 2) establishes a state-sponsored prescription drug discount card program for residents with annual incomes up to 200 percent of federal poverty guideline. The program may use voluntary manufacturer rebates but may not use formularies or preferred drug lists; 3) establishes a state Council that "shall establish a pricing schedule using or referencing the FSS (Federal Supply Schedule) prices", which requires a future, additional legislative vote of approval or rejection. Also provides that the state shall "explore the feasibility of using or referencing, the federal supply schedule or Canadian pricing. 4) Requires the state to "investigate the feasibility of purchasing prescription drugs from Canada," including feasibility of serving as a wholesale distributor of prescription drugs in the state." 5)  Requires reporting of Rx advertising costs. 6) Requires an immediate study of the fiscal impact of the MMA, with a report due October 2004.
(filed; passed House 1/22/04; passed Senate and Conference 3/13/04, signed by governor 4/7/04) | ALSO SEE SCR 301, below
WV Pharmaceutical Cost Management Council - website, updated 2008 Bulk, CL, D, Imp, M, MMA, Mkt, PDL, Price, Study

WV
HB 4637
Del. Fleischauer
Would establish the West Virginia Prescription Drug Ethical Marketing Act.
(Filed and sent to committee 2/26/04; did not pass by end of regular session 3/20/04) | Mkt

WV
SCR 301
Joint resolution, which authorizes the use of the Federal Supply Schedule (FSS) as a benchmark for the negotiation and purchase of brand-name pharmaceuticals. The House approved three recommendations of the Cost Management Council, created by House Bill 4084 in April 2004, and authorized the Council to proceed with the implementation of its strategic plan. This Council will report back to the Legislature with any recommended legislation and/or rules.
(Filed in 3rd special session; passed Senate and House 11/16; signed by governor 11/04) D, Price

WI
AB 689
Rep. Wieckert
Would add a requirement for prescription drug labels to include the symptom or purpose for which the drug is being prescribed if the patient wants the symptom or purpose to appear on the label.
(Filed 12/5/03; amended 3/2/04; did not pass committee 3/31/04) | Lab

WI
AB 785
Rep. Seratti
Would require the state to provide a Web site with information on the 50 most commonly prescribed prescription drugs, including the highest, lowest, and average retail prices of each.
(Filed and sent to committee 2/2/04; did not pass committee 3/31/04) | CL, Imp, Price

WI
AB 840
Rep. Underheim
Would require each manufacturer or labeler to pay an assessment based on the total claims paid by the Health Insurance Risk Sharing Plan the previous year to pharmacies and pharmacists for the manufacturer's or labeler's drugs.
(Filed 2/16/04; did not pass committee 3/31/04) | -

WI
AB 845
Rep. Underheim
Establishes a cancer drug repository program under which any person may donate a cancer drug to a medical facility or pharmacy that elects to participate in the program and meets requirements specified by the state.
(Filed 2/16/04; passed Assembly 2/25/04; passed Senate 3/4/04; signed by governor as Act 175 4/6/04) | Re

WI
AB 876
Rep. Krusick
Would create the Pharmacy Outreach Program to provide patients with information about their eligibility for pharmaceutical manufacturer patient assistance programs; provides health care providers with opportunities to work with pharmaceutical manufacturer representatives to improve the programs.
(Filed 2/23/04; did not pass committee 3/31/04) | CL

WI
AB 896
Rep. Shilling,
AB 995
Rep. Wasserman
Would expand eligibility by treating property taxes as exempt from income limits for the prescription drug assistance program for the elderly.
(Filed 2/23/04; did not pass committee 3/31/04) | S

WI
AJR 71
Rep. Pocan,
SJR 46,
Sen. Robson Non-binding resolutions, would urge Congress to enact legislation allowing individuals and pharmacies to import prescription medicines purchased in other countries that have regulatory safeguards for the manufacture and distribution of drugs comparable to the United States.
(AJR 71 passed Assembly; did not pass in Senate; SJR 46 failed to be adopted 3/31/04) | Imp

WI
SB 418
Sen. Hansen
Would treat property taxes as a deduction to annual household income for purposes of determining eligibility and deductible amounts under the prescription drug assistance program for the elderly.
(Filed 2/3/04; did not pass committee 3/31/04) | S

WI
SR 31
Sen. Brown
Non-binding resolution, urges Congress and the administration to create "a safe and legitimate program for prescription drug importation or through negotiated trade agreements with other industrialized nations."
(Filed 3/4/04; adopted by Senate 17y-14n, 3/9/04) | Imp

WY
HB 1
Appropriations
Comm.
The FY05-06 budget:
1) Sec. 48 requires the state to use an asset test "to ensure the funds appropriated for the state's Prescription Drug Assistance Program (PDAP) will be sufficient to fund the program" through June 2006. It appropriates a total of $85 million for Medicaid pharmaceuticals, including the PDAP state subsidy program.
2) Requires "those individuals who are eligible for the Medicare prescription drug card and for whom the card is cost effective," to use the subsidy provided with the card as a condition of participation in the prescription drug assistance program.
3) Requires that the Department of Health "shall not agree to any Medicaid waiver" such as Pharmacy Plus, where the federal government, as a condition of granting the waiver, requires the state to agree to any limit on the normal federal cost share in the program where the state expenditures are not comparably restricted.
4) Sec. 310 requires executive and legislative offices to each prepare a cost/benefit report on the savings realized and costs incurred in any prescription drug cost-containment measure including a preferred drug list, prior authorization, refill too soon program, lock-in program for narcotics, state maximum allowable cost program, or quantity limitations."
(Filed, passed House and Senate; signed by governor as Chapter 95, 3/04)} (Sec. 128o)| MMA, P+, S, M, study

WY
H.B. 198
Rep. Meuli
Would provide that the state will pay for drugs in the Medical Assistance and Services Act programs when a prescriber specifies "medically necessary" prescription drugs without prior authorization or requirements imposed by a preferred drug list.
(Filed and sent to committee 2/11/04; did not pass by end of regular session 3/4/04)| M, PDL

Footnotes:
¹This report includes bills that would create binding state laws, budget bills that would appropriate funds plus non-binding resolutions and memorials. The District of Columbia also is listed. The totals and summaries may combine these measures. A vertical line ( | ) after the bill status indicates final action for the calendar year.

²Cost trends for private insurers. From Milliman USA Health Cost Index, Center for Studying Health System Change, 2003.

NCSL Resources:

Pharmaceuticals Menu Page, 2008 - an online menu of more than 30 reports, articles and presentations by NCSL.
State Pharmaceutical Assistance Programs - report on the existing and enacted programs for subsidies and discounts in 39 states, updated regularly.

Authors: This report was researched and compiled by Karmen Hanson and Richard Cauchi, NCSL Health Program, Denver, Colorado.

Methodology: Legislation listed reflects several combined sources: 1) direct searches of state legislative web sites, 2) 50-state keyword searches with data from Westlaw (c) and Statenet (c) and 3) consultation with individual state contacts. Bill status is simpified to reflect examples of major actions. Since status and wording may change frequently, the authors recommend using the bill links provided to obtain details on legislative content, actions, amendments and sponsors.
Note on Design: The table above uses background color (yellow or light gold) to emphasize measures that have become law or completed final passage.

View this report online at: www.ncsl.org/programs/health/drugdisc04.htm

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